Nursing Elites

1. A client has a new prescription for a combination of oral NRTIs (abacavir, lamivudine, and zidovudine) for the treatment of HIV. Which of the following statements should the nurse include in teaching the client?

• A. These medications work by blocking HIV entry into cells.
• B. These medications work by weakening the cell wall of the HIV virus.
• C. These medications work by inhibiting enzymes to prevent HIV replication.
• D. These medications work by preventing protein synthesis within the HIV cell.

Correct answer: C

Rationale: The NRTI antiretroviral medications this client is prescribed work by inhibiting the enzyme reverse transcriptase, thus preventing HIV replication. By inhibiting this crucial enzyme, the drug interferes with the virus's ability to replicate and spread in the body. Choice A is incorrect because NRTIs do not block HIV entry into cells. Choice B is incorrect as NRTIs do not weaken the cell wall of the virus. Choice D is incorrect as NRTIs do not prevent protein synthesis within the HIV cell.

2. A nurse reviewing a client's medical record notes a new prescription for verifying the trough level of the client's medication. Which of the following actions should the nurse take?

• A. Obtain a blood specimen immediately prior to administering the next dose of medication.
• B. Verify that the client has been taking the medication for 24 hours before obtaining a blood specimen.
• C. Ask the client to provide a urine specimen after the next dose of medication.
• D. Administer the medication and obtain a blood specimen 30 minutes later.

Correct answer: A

Rationale: To verify the trough levels of a medication accurately, the nurse should obtain a blood specimen immediately before administering the next dose of the medication. The trough level represents the lowest concentration of the medication in the bloodstream, typically right before the next dose is due. This timing ensures an accurate assessment of the drug's concentration in the body at its lowest point, aiding in determining the drug's effectiveness and potential toxicity levels. Choice B is incorrect because waiting for 24 hours would not provide the trough level. Choice C is incorrect as urine specimens are not used to measure trough levels. Choice D is incorrect as obtaining a blood specimen 30 minutes after administering the medication would not reflect the trough level.

3. A client is taking Furosemide for heart failure. Which of the following findings is a priority to report to the provider?

• A. Weight loss of 1 kg in 24 hours
• B. Blood pressure of 104/60 mm Hg
• C. Potassium level of 3.5 mEq/L
• D. Urine output of 200 mL in 8 hours

Correct answer: D

Rationale: A urine output of 200 mL in 8 hours indicates decreased kidney function and potential worsening heart failure. This finding should be reported promptly to the provider for further evaluation and management to prevent complications. Weight loss, while significant, may be expected with diuretic use. A blood pressure of 104/60 mm Hg is within normal range and can be managed. A potassium level of 3.5 mEq/L is slightly low but not an immediate concern.

4. When caring for a school-age child with a new prescription for Atomoxetine, the nurse should monitor the client for which of the following adverse effects of this medication?

• A. Kidney toxicity
• B. Liver damage
• C. Seizure activity
• D. Adrenal insufficiency

Correct answer: B

Rationale: The correct answer is B: Liver damage. Atomoxetine can lead to liver damage as an adverse effect. Symptoms of liver damage include jaundice, upper abdominal tenderness, dark urine, and elevated liver enzymes. Monitoring for these signs is crucial when a child is on this medication. Choices A, C, and D are incorrect because Atomoxetine is not known to cause kidney toxicity, seizure activity, or adrenal insufficiency as primary adverse effects.

5. Which of the following conditions is not treated with Prednisone?

• A. Cushing’s disease
• B. Testicular cancer
• C. Lymphomas
• D. Chronic leukemias

Correct answer: B

Rationale: Prednisone is not a common treatment for testicular cancer. Prednisone is used in conditions like Cushing’s disease, lymphomas, and chronic leukemias due to its anti-inflammatory and immunosuppressive properties. However, testicular cancer treatment typically involves surgery, chemotherapy, and radiation therapy, but not Prednisone.

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