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Rationale: When administering Filgrastim, only one dose should be withdrawn from the vial, and the vial should then be discarded to prevent any contamination or errors in dosing.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. A client with renal failure and an elevated phosphorus level is prescribed aluminum hydroxide 300 mg PO three times daily. For which of the following adverse effects should the nurse inform the client?

• A. Constipation
• B. Metallic taste
• C. Headache
• D. Muscle spasms

Correct answer: A

Rationale: Correct. Aluminum hydroxide is known to cause constipation as a common side effect. Instructing the client about this potential adverse effect is important for their awareness and management. The other options, metallic taste, headache, and muscle spasms, are not typically associated with aluminum hydroxide use. Therefore, the nurse should focus on educating the client about the increased risk of constipation and provide guidance on managing this side effect to improve the client's comfort and treatment adherence.

3. A client is prescribed Ranitidine. Which of the following laboratory results should be monitored by the nurse?

• A. Complete blood count (CBC).
• B. Serum creatinine.
• C. Serum potassium.
• D. Serum glucose.

Correct answer: A

Rationale: Ranitidine can potentially lead to blood dyscrasias, necessitating the monitoring of the client's CBC. Checking the CBC can help detect any abnormalities in blood cell counts and assess the client's overall hematologic status during Ranitidine therapy.

4. A healthcare professional is preparing to administer dextrose 5% in water (D5W) 750 mL IV to infuse over 6 hr. How many mL/hr should the IV pump be set to deliver?

• A. 125 mL/hr
• B. 100 mL/hr
• C. 150 mL/hr
• D. 200 mL/hr

Correct answer: A

Rationale: To calculate the flow rate, divide the total volume by the total time: 750 mL / 6 hr = 125 mL/hr. Therefore, the IV pump should be set to deliver 125 mL/hr to infuse D5W 750 mL over 6 hours. Choice B (100 mL/hr) is incorrect because it does not accurately divide the total volume by the total time. Choice C (150 mL/hr) and Choice D (200 mL/hr) are incorrect as they are not the correct flow rates needed to infuse the D5W solution over the specified time period.

5. Which of the following is not a side effect of the vasodilator Nifedipine?

• A. Nausea
• B. Flushed appearance
• C. Vertigo
• D. Sexual dysfunction

Correct answer: D

Rationale: Sexual dysfunction is not a common side effect of vasodilators such as Nifedipine. Nausea, flushed appearance, and vertigo are more commonly reported side effects associated with this medication. It's essential for healthcare providers to be aware of the potential side effects to monitor and manage them effectively in patients prescribed with Nifedipine.

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