Nursing Elites

1. A client has a new prescription for Hydroxychloroquine to treat Lupus Erythematosus. Which of the following adverse effects should the nurse include in the teaching?

• A. Nausea
• B. Hair loss
• C. Eye damage
• D. Drowsiness

Correct answer: C

Rationale: The correct answer is 'C: Eye damage.' Hydroxychloroquine can cause severe adverse effects on the eyes, such as retinopathy, which can lead to permanent visual impairment. It is essential for clients to be aware of this potential adverse effect and report any changes in vision promptly. Choices A, B, and D are incorrect because although nausea, hair loss, and drowsiness can occur with Hydroxychloroquine, they are not as severe or critical as the risk of eye damage.

2. A healthcare professional is reviewing a client's health record and notes that the client experiences permanent extrapyramidal effects caused by a previous medication. The healthcare professional should recognize that the medication affected which of the following systems in the client?

• A. Cardiovascular
• B. Immune
• C. Central nervous
• D. Gastrointestinal

Correct answer: C

Rationale: The correct answer is C: Central nervous. Extrapyramidal effects are movement disorders caused by certain medications affecting the central nervous system. These effects can include symptoms like tremors, rigidity, and bradykinesia. Medications like typical antipsychotics induce extrapyramidal effects by interfering with dopamine transmission in the central nervous system. Choices A, B, and D are incorrect as extrapyramidal effects are specifically related to the central nervous system and not the cardiovascular, immune, or gastrointestinal systems.

3. A client has a new prescription for alendronate to treat osteoporosis. Which of the following instructions should be included?

• A. Take the medication with food to reduce nausea.
• B. Take the medication first thing in the morning on an empty stomach.
• C. Take the medication with a full glass of milk.
• D. Take the medication with meals.

Correct answer: B

Rationale: Alendronate should be taken first thing in the morning on an empty stomach to maximize absorption. Taking it with food, milk, or meals can reduce its effectiveness by impairing absorption. Therefore, advising the client to take it on an empty stomach is crucial for optimal therapeutic outcomes.

4. A healthcare provider is reviewing the health care record of a client who is asking about conjugated equine estrogens. The healthcare provider should inform the client this medication is contraindicated in which of the following conditions?

• A. Atrophic vaginitis
• B. Dysfunctional uterine bleeding
• C. Osteoporosis
• D. Thrombophlebitis

Correct answer: D

Rationale: Conjugated equine estrogens are contraindicated in individuals with a history of thrombophlebitis due to the increased risk of thrombotic events associated with estrogen use. Thrombophlebitis is a condition characterized by inflammation and blood clot formation in the veins, and estrogen therapy can exacerbate this condition, leading to serious complications such as deep vein thrombosis. Therefore, caution is advised when considering estrogen therapy in clients with a history of thrombophlebitis to prevent adverse outcomes. Choices A, B, and C are not contraindications for conjugated equine estrogens. Atrophic vaginitis and dysfunctional uterine bleeding may actually be conditions for which estrogen therapy is indicated. Osteoporosis can also be managed with estrogen therapy in certain cases to help prevent bone density loss.

5. A client receiving chemotherapy with Methotrexate asks why Leucovorin is being given. Which of the following responses should the nurse use?

• A. Leucovorin reduces the risk of a transfusion reaction from Methotrexate.
• B. Leucovorin increases platelet production and prevents bleeding.
• C. Leucovorin potentiates the cytotoxic effects of Methotrexate.
• D. Leucovorin protects healthy cells from Methotrexate's toxic effects.

Correct answer: D

Rationale: Leucovorin, a folic acid derivative and an antagonist to Methotrexate, is given within 12 hours of high doses of Methotrexate to protect healthy cells from the toxic effects of Methotrexate. It helps to reduce the bone marrow suppression and gastrointestinal side effects caused by Methotrexate, supporting the client's overall well-being during chemotherapy treatment. Choices A, B, and C are incorrect because Leucovorin does not reduce the risk of a transfusion reaction from Methotrexate, increase platelet production, prevent bleeding, or potentiate the cytotoxic effects of Methotrexate. Instead, Leucovorin works by rescuing healthy cells from the toxic effects of Methotrexate.

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