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 client presents in the Emergency Department with a suspected MI. Which medication should NOT be given as soon as possible?

• A. Clopidogrel (Plavix)
• B. Morphine
• C. Aspirin (ASA)
• D. Metoprolol (Lopressor)

Correct answer: A

Rationale: In the setting of a suspected myocardial infarction (MI), the priority medications to administer as soon as possible include aspirin (ASA) and possibly morphine to manage pain and anxiety. Clopidogrel (Plavix) is not typically administered immediately in the emergency setting for MI management. Metoprolol (Lopressor) is indicated after aspirin administration and stabilization of the patient. Therefore, in this scenario, clopidogrel should NOT be given as a first-line medication for a suspected MI.

3. A client with Addison's disease is being admitted for a total hip arthroplasty. The client takes hydrocortisone for Addison's disease. What is the nurse's priority action?

• A. Administering a supplemental dose of hydrocortisone
• B. Instructing the client about coughing and deep breathing
• C. Collecting additional information from the client about his history of Addison's disease
• D. Inserting an indwelling urinary catheter

Correct answer: A

Rationale: The nurse's priority in this situation is to administer a supplemental dose of hydrocortisone. Clients with Addison's disease taking hydrocortisone are at risk of acute adrenal insufficiency during times of stress such as surgery. Administering supplemental doses of hydrocortisone helps prevent acute adrenal insufficiency (adrenal crisis) in these situations, making it the priority action to ensure the client's safety. Instructing the client about coughing and deep breathing is important postoperatively but not the priority at this time. Collecting additional information about the client's history of Addison's disease is important but not the priority action before surgery. Inserting an indwelling urinary catheter is not the priority in this situation.

4. A client has ordered a thrombolytic medication for the treatment of CVA. Which type of stroke should not be treated with a thrombolytic?

• A. Hemorrhagic stroke
• B. Thrombotic stroke
• C. Both types can be treated with a thrombolytic
• D. Neither type can be treated with a thrombolytic

Correct answer: A

Rationale: Thrombolytic medications are used to dissolve blood clots. In the case of a hemorrhagic stroke, where there is bleeding in the brain, the use of thrombolytics can worsen the condition by increasing bleeding. Therefore, hemorrhagic strokes should not be treated with thrombolytic medications.

5. A client will start Alfuzosin for the treatment of Benign Prostatic Hyperplasia. The nurse should instruct the client that which of the following is an adverse effect of this medication?

• A. Bradycardia
• B. Edema
• C. Hypotension
• D. Tremor

Correct answer: C

Rationale: The correct answer is C, Hypotension. Alfuzosin relaxes muscle tone in veins, leading to vasodilation and reduced systemic vascular resistance. This effect can cause hypotension due to decreased cardiac output. Clients should be advised to rise slowly from a sitting or lying position to minimize the risk of orthostatic hypotension. Choices A, B, and D are incorrect because bradycardia, edema, and tremor are not commonly associated adverse effects of Alfuzosin.

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