Nursing Elites

1. A client is being discharged with a new prescription for furosemide 40 mg PO daily. Which of the following instructions should be included?

• A. Avoid foods rich in potassium.
• B. Take the medication with food.
• C. Weigh yourself daily.
• D. Stand up slowly to minimize orthostatic hypotension.

Correct answer: D

Rationale: The correct answer is D: 'Stand up slowly to minimize orthostatic hypotension.' Clients prescribed furosemide are at risk for orthostatic hypotension, a sudden drop in blood pressure when changing positions. Advising the client to stand up slowly can help prevent this complication. Instructing the client to avoid rapid position changes decreases the likelihood of dizziness or fainting episodes. Choices A, B, and C are incorrect because furosemide does not require avoiding potassium-rich foods, taking the medication with food, or daily weighing as specific instructions.

2. A client with Hodgkin's disease is receiving Cyclophosphamide IV. Which medication should be administered concurrently to prevent an adverse effect of Cyclophosphamide?

• A. Uroprotectant agent, such as mesna
• B. Opioid, such as morphine
• C. Loop diuretic, such as furosemide
• D. H1 receptor antagonist, such as diphenhydramine

Correct answer: A

Rationale: Mesna, an uroprotectant agent, is administered with nitrogen mustard chemotherapy drugs like Cyclophosphamide to prevent hemorrhagic cystitis, a common adverse effect. Mesna works by binding to and inactivating the toxic metabolites of Cyclophosphamide in the bladder, thereby reducing the risk of bladder toxicity.

3. A nurse is assessing a client who is receiving IV vancomycin. The nurse notes a flushing of the neck and tachycardia. Which of the following actions should the nurse take?

• A. Document that the client experienced an anaphylactic reaction to the medication.
• B. Change the IV infusion site.
• C. Decrease the infusion rate on the IV.
• D. Apply cold compresses to the neck area.

Correct answer: C

Rationale: Flushing and tachycardia are signs of Red Man Syndrome, which can be mitigated by decreasing the infusion rate.

4. A client is prescribed Clopidogrel. Which of the following laboratory values should the nurse monitor to assess for potential adverse effects?

• A. White blood cell count
• B. Platelet count
• C. Hemoglobin
• D. Blood glucose

Correct answer: B

Rationale: Clopidogrel is an antiplatelet medication that works by inhibiting platelet aggregation. Therefore, the nurse should monitor the client's platelet count to assess for potential bleeding complications. Changes in platelet count can indicate the effectiveness of Clopidogrel therapy and help prevent adverse effects related to clotting or bleeding. Monitoring white blood cell count, hemoglobin, or blood glucose levels is not directly related to the action or side effects of Clopidogrel.

5. A client has a new prescription for Pancrelipase for chronic pancreatitis. Which of the following instructions should be included by the nurse?

• A. Take the medication with meals and snacks.
• B. Chew the tablet thoroughly before swallowing.
• C. Take the medication 1 hour before meals.
• D. Expect the stool to be yellow.

Correct answer: A

Rationale: The correct instruction for taking Pancrelipase is to take it with meals and snacks to aid in the digestion of fats, proteins, and carbohydrates. This helps optimize the effectiveness of the medication in managing chronic pancreatitis. Choice B is incorrect because Pancrelipase should not be chewed but swallowed whole. Choice C is incorrect as the medication should be taken with meals. Choice D is incorrect because while Pancrelipase can cause stool changes, yellow stool is not an expected outcome.

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