Nursing Elites

1. 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.

2. A healthcare professional is reviewing the laboratory results of a client taking Warfarin for atrial fibrillation. Which of the following findings should the professional report to the provider immediately?

• A. INR of 4.0
• B. Potassium level of 4.5 mEq/L
• C. Creatinine level of 1.0 mg/dL
• D. BUN of 18 mg/dL

Correct answer: A

Rationale: An INR of 4.0 indicates that the client's blood is clotting too slowly, increasing the risk of bleeding. This level is above the therapeutic range for a client on Warfarin therapy. Therefore, the healthcare professional should notify the provider immediately to prevent potential bleeding complications. The other laboratory values are within normal limits and do not pose an immediate risk to the client's health while on Warfarin therapy.

3. A client has a new prescription for Levodopa/Carbidopa for Parkinson's disease. Which of the following instructions should the nurse include?

• A. Increase intake of protein-rich foods.
• B. Expect muscle twitching to occur.
• C. Take this medication with food.
• D. Anticipate relief of manifestations in 24 hours.

Correct answer: C

Rationale: The correct instruction the nurse should include is to take Levodopa/Carbidopa with food. Taking this medication with food helps reduce gastrointestinal side effects. Instructing the client to take the medication with food promotes better tolerance and absorption of the drug. Choice A is incorrect because increasing protein-rich foods is not specifically related to the administration of this medication. Choice B is incorrect as muscle twitching is not a common side effect of Levodopa/Carbidopa. Choice D is incorrect because relief of manifestations may take longer than 24 hours to occur.

4. When administering Amitriptyline to a client experiencing cancer pain, for which of the following adverse effects should the nurse monitor?

• A. Decreased appetite
• B. Explosive diarrhea
• C. Decreased pulse rate
• D. Orthostatic hypotension

Correct answer: D

Rationale: The correct answer is 'Orthostatic hypotension.' When administering Amitriptyline, the nurse should monitor for orthostatic hypotension. This condition can occur due to the drug's anticholinergic effects, leading to a sudden drop in blood pressure when standing up. Symptoms may include dizziness, lightheadedness, and an increased risk of falls. Monitoring for signs of orthostatic hypotension is crucial to prevent complications. Choices A, B, and C are incorrect as decreased appetite, explosive diarrhea, and decreased pulse rate are not typically associated with the administration of Amitriptyline.

5. A client has a new prescription for hydrochlorothiazide to treat hypertension. Which of the following instructions should be included?

• A. Take the medication in the morning.
• B. Increase intake of potassium-rich foods.
• C. Avoid sun exposure while taking this medication.
• D. Limit fluid intake to 1 liter per day.

Correct answer: B

Rationale: The correct instruction that should be included for a client prescribed hydrochlorothiazide is to increase the intake of potassium-rich foods. Hydrochlorothiazide, being a diuretic, can lead to hypokalemia by enhancing potassium excretion. Increasing consumption of potassium-rich foods like bananas or oranges can help prevent hypokalemia and maintain electrolyte balance. Choices A, C, and D are incorrect. Taking the medication in the morning is not a specific instruction related to hydrochlorothiazide. Avoiding sun exposure is more relevant for photosensitive medications, not hydrochlorothiazide. Limiting fluid intake to 1 liter per day is not necessary unless specifically advised by a healthcare provider.

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