Nursing Elites

1. A healthcare professional is preparing to administer Filgrastim for the first time to a client who has just undergone a bone marrow transplant. Which of the following interventions is appropriate?

• A. Administer intravenously to prevent injury.
• B. Ensure that the medication is kept refrigerated until just prior to administration.
• C. Do not shake the vial; gently invert it to mix before withdrawing the dose.
• D. Discard the vial after removing one dose of the medication.

Correct answer: D

Rationale: When administering Filgrastim, only one dose should be withdrawn from the vial, and the vial should then be discarded to prevent any contamination or errors in dosing. It is crucial not to shake the vial but gently invert it to mix the medication before withdrawing the appropriate dose. Refrigeration is not required for Filgrastim; it should be stored at room temperature until just before administration. Choice A is incorrect because Filgrastim is typically administered subcutaneously, not intravenously. Choice B is incorrect as the medication should be stored at room temperature, not refrigerated, until administration. Choice C is incorrect as shaking the vial is not recommended for Filgrastim.

2. When teaching a client with a new prescription for Simvastatin, which instruction should be included?

• A. Take this medication with food.
• B. Avoid drinking grapefruit juice.
• C. Take this medication in the morning.
• D. Increase your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct instruction for a client with a new prescription for Simvastatin is to avoid drinking grapefruit juice. Grapefruit juice can inhibit the metabolism of Simvastatin, leading to increased blood levels of the drug and a higher risk of adverse effects such as muscle pain and liver damage. It is important to educate the client about this potential interaction to ensure the safe and effective use of the medication. Choices A, C, and D are incorrect because taking Simvastatin with food or in the morning and increasing potassium-rich foods intake are not specifically related to the safe use of Simvastatin. Avoiding grapefruit juice is crucial to prevent drug interactions.

3. A client is receiving discharge instructions for long-term use of Prednisone. Which of the following instructions should be included?

• A. Stop taking the medication if you experience swelling.
• B. The provider will monitor your weight regularly.
• C. Take the medication on an empty stomach.
• D. You may notice decreased appetite while on this medication.

Correct answer: B

Rationale: The correct answer is B because long-term use of Prednisone can lead to weight gain, necessitating regular weight monitoring by the healthcare provider to manage any potential complications. Prednisone often causes fluid retention, leading to weight gain, hence the need for weight monitoring. Options A, C, and D are incorrect because swelling is not a typical reason to stop Prednisone, taking it on an empty stomach is not usually required, and Prednisone commonly increases appetite rather than decreases it.

4. Which of the following is a potassium-sparing diuretic?

• A. Furosemide
• B. Spironolactone
• C. Hydrochlorothiazide
• D. Bumetanide

Correct answer: B

Rationale: Spironolactone is classified as a potassium-sparing diuretic. It works by antagonizing the aldosterone receptor, leading to potassium retention and sodium excretion. This mechanism makes it a suitable choice for conditions where potassium retention is desired, such as in patients with heart failure or liver cirrhosis. Choices A, C, and D are not potassium-sparing diuretics. Furosemide, hydrochlorothiazide, and bumetanide are loop diuretics and thiazide diuretics, respectively, which promote the excretion of potassium.

5. A client has a prescription for Amoxicillin. Which of the following instructions should be included?

• A. Take the medication with food.
• B. Avoid taking the medication with milk.
• C. Expect your stools to turn clay-colored.
• D. Complete the entire course of therapy.

Correct answer: D

Rationale: The correct answer is D: Complete the entire course of therapy. It is crucial for clients to complete the entire course of amoxicillin therapy to ensure the infection is fully treated and to prevent antibiotic resistance. Prematurely stopping the antibiotic can lead to incomplete eradication of the infection, potentially causing it to return and be more difficult to treat. Choices A and B are not specific to amoxicillin and are general medication administration instructions. Choice C is not a common side effect of amoxicillin and does not require patient education.

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