Nursing Elites

1. A client is taking Epoetin Alfa for anemia. Which of the following laboratory tests should the nurse monitor to evaluate the effectiveness of the therapy?

• A. White blood cell count
• B. Platelet count
• C. Hematocrit
• D. Serum potassium level

Correct answer: C

Rationale: The nurse should monitor the hematocrit level to evaluate the effectiveness of Epoetin Alfa therapy since it stimulates red blood cell production. Hematocrit reflects the volume of red blood cells in the blood, providing a direct measure of the therapy's impact on increasing red blood cell mass and addressing anemia. Monitoring white blood cell count and platelet count is not directly related to assessing the effectiveness of Epoetin Alfa therapy for anemia. Serum potassium level monitoring may be necessary due to potential side effects of the medication, but it is not the primary indicator of therapy effectiveness in treating anemia.

2. A client is receiving combination chemotherapy. Which of the following findings should the nurse identify as an indication of an oncologic emergency?

• A. Dry oral mucous membranes
• B. Nausea and vomiting
• C. Temperature of 38.1°C (100.6°F)
• D. Anorexia

Correct answer: C

Rationale: A temperature of 38.1°C (100.6°F) can indicate an infection, which is considered an oncologic emergency in clients receiving chemotherapy due to the increased risk of sepsis in immunocompromised individuals. Dry oral mucous membranes (Choice A), nausea and vomiting (Choice B), and anorexia (Choice D) are common side effects of chemotherapy but do not typically indicate an oncologic emergency requiring immediate intervention.

3. A client with Schizophrenia is taking Risperidone. Which of the following instructions should the nurse include in the teaching?

• A. Increase your intake of snacks to prevent weight loss.
• B. Notify the provider if you develop breast enlargement.
• C. Be aware of the possibility of mild seizures while taking this medication.
• D. Expect an increase in libido when taking this medication.

Correct answer: B

Rationale: The correct instruction the nurse should provide to the client taking Risperidone for Schizophrenia is to notify the provider if they develop breast enlargement. Risperidone can lead to an increase in prolactin levels, causing gynecomastia (breast enlargement) and galactorrhea. Therefore, it is crucial for the client to report these manifestations to the healthcare provider for appropriate management. Choices A, C, and D are incorrect. Increasing snack intake to prevent weight loss is not a specific concern related to Risperidone. Mild seizures are not a common side effect of Risperidone, so this instruction is unnecessary. Risperidone is more likely to cause sexual side effects like decreased libido rather than an increase.

4. A client asks the nurse how Rituximab works, which the client is receiving to treat Non-Hodgkin's Leukemia. Which of the following should the nurse include?

• A. Blocks hormone receptors
• B. Increases immune response
• C. Binds with specific antigens on tumor cells
• D. Stops DNA replication during cell division

Correct answer: C

Rationale: Rituximab is a monoclonal antibody that binds with specific antigens on B-lymphocytes, leading to the destruction of cancer cells. In the context of Non-Hodgkin's Leukemia, Rituximab targets and destroys cancerous B-lymphocytes, which helps in treating the disease. Choices A, B, and D are incorrect. Rituximab does not block hormone receptors, increase immune response, or stop DNA replication during cell division. The primary mode of action of Rituximab is its binding with specific antigens on tumor cells, specifically B-lymphocytes, to elicit an immune response against cancerous cells.

5. A client has a new prescription for Captopril for hypertension. The nurse should monitor the client for which of the following adverse effects of this medication?

• A. Hypokalemia
• B. Hypernatremia
• C. Neutropenia
• D. Bradycardia

Correct answer: C

Rationale: Neutropenia is a serious adverse effect associated with ACE inhibitors like Captopril. Neutropenia refers to a decreased level of neutrophils, which are important white blood cells in fighting infection. Monitoring the client's complete blood count (CBC) is essential to detect neutropenia early. Hypokalemia (Choice A) is more commonly associated with diuretics, not ACE inhibitors. Hypernatremia (Choice B) is an increase in sodium levels, not typically caused by Captopril. Bradycardia (Choice D) is not a common adverse effect of ACE inhibitors like Captopril.

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