Nursing Elites

1. A healthcare professional is reviewing the laboratory results for a client who has a prescription for filgrastim. The healthcare professional should recognize that an increase in which of the following values indicates a therapeutic effect of this medication?

• A. Erythrocyte count
• B. Neutrophil count
• C. Lymphocyte count
• D. Thrombocyte count

Correct answer: B

Rationale: Filgrastim is a medication used to stimulate the production of neutrophils in patients with neutropenia. Neutrophils are a type of white blood cell that plays a crucial role in fighting off infections. Therefore, an increase in neutrophil count would indicate a therapeutic effect of filgrastim. The other options, such as erythrocyte count (red blood cells), lymphocyte count, and thrombocyte count (platelets), are not directly affected by filgrastim and would not indicate a therapeutic effect of this medication.

2. A nurse in an outpatient facility is assessing a client who is prescribed furosemide 40 mg daily, but the client reports she has been taking extra doses to promote weight loss. Which of the following indicates she is dehydrated?

• A. Urine specific gravity of 1.035
• B. Oliguria
• C. Increased urine concentration
• D. Dry mucous membranes

Correct answer: A

Rationale: The correct answer is A: Urine specific gravity of 1.035. A urine specific gravity greater than 1.030 indicates dehydration as the kidneys conserve water in response to dehydration. Choice B, oliguria, refers to decreased urine output, which can be a sign of dehydration but is not specific to it. Choice C, increased urine concentration, is a general term and does not directly indicate dehydration. Choice D, dry mucous membranes, can be a sign of dehydration but is not as specific as a urine specific gravity greater than 1.030.

3. A nurse is caring for a client who has a prescription for chlorothiazide to treat hypertension. The nurse should plan to monitor the client for which of the following adverse effects?

• A. Thrombophlebitis
• B. Hyperactive reflexes
• C. Muscle weakness
• D. Hypoglycemia

Correct answer: C

Rationale: The correct answer is C: Muscle weakness. Chlorothiazide, a thiazide diuretic, can lead to hypokalemia, which can cause muscle weakness. Thrombophlebitis (choice A) is not typically associated with chlorothiazide use. Hyperactive reflexes (choice B) and hypoglycemia (choice D) are also not commonly linked to this medication. Therefore, monitoring for muscle weakness is crucial when a client is prescribed chlorothiazide.

4. A client with a seizure disorder has a new prescription for valproic acid. Which of the following laboratory values should the nurse plan to monitor? (Select all that apply)

• A. PTT
• B. Aspartate aminotransferase (AST)
• C. Alanine aminotransferase (ALT)
• D. All of the Above

Correct answer: D

Rationale: The correct answer is D, 'All of the Above.' Valproic acid can impact liver function and coagulation. Monitoring the Prothrombin Time (PTT), Aspartate Aminotransferase (AST), and Alanine Aminotransferase (ALT) is crucial. PTT is monitored to assess coagulation status, while AST and ALT are liver enzymes that indicate liver function. Monitoring these values helps detect any potential adverse effects of valproic acid on the liver and blood clotting. Choices A, B, and C are incorrect because each of these laboratory values plays a critical role in evaluating the client's response to valproic acid therapy and detecting associated complications.

5. A nurse is caring for a client who has a new prescription for enalapril. The nurse should monitor the client for which of the following adverse effects of this medication?

• A. Ecchymosis
• B. Jaundice
• C. Hypotension
• D. Hypokalemia

Correct answer: C

Rationale: The correct answer is C: Hypotension. Enalapril, an ACE inhibitor, can lead to hypotension, especially after the first dose. Choices A, B, and D are incorrect because enalapril is not typically associated with ecchymosis, jaundice, or hypokalemia as common adverse effects. Therefore, the nurse should primarily monitor the client for signs of hypotension.

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