Nursing Elites

1. A healthcare professional is educating a client who is beginning therapy with gemcitabine. Which of the following findings should the healthcare professional instruct the client to report?

• A. Dyspnea
• B. Constipation
• C. Tinnitus
• D. Dry mouth

Correct answer: A

Rationale: The correct answer is dyspnea. Dyspnea can indicate pulmonary toxicity, a severe adverse effect associated with gemcitabine therapy. Prompt reporting of dyspnea allows for timely evaluation and management to prevent potential complications. Constipation, tinnitus, and dry mouth are not typically associated with gemcitabine therapy and are less likely to be directly related to the medication. Therefore, they are not the priority findings that the client should report.

2. A healthcare professional is reviewing the medication list of a client who has a new prescription for Metformin to treat type 2 diabetes. Which of the following medications should the healthcare professional identify as placing the client at risk for lactic acidosis?

• A. Metformin
• B. Metoprolol
• C. Lisinopril
• D. Insulin

Correct answer: A

Rationale: Metformin is known to have a risk of causing lactic acidosis, particularly in clients with renal impairment or predisposing conditions. Lactic acidosis is a rare but serious adverse effect of metformin use that can be life-threatening. Metoprolol, Lisinopril, and Insulin do not have a known association with lactic acidosis. Healthcare professionals should monitor clients prescribed metformin carefully, especially those with risk factors, to detect and manage lactic acidosis promptly.

3. A client has a new prescription for Calcitonin-salmon for Osteoporosis. Which of the following tests should the nurse tell the client to expect before beginning this medication?

• A. Skin test for allergy to the medication
• B. ECG to rule out cardiac dysrhythmias
• C. Mantoux test to rule out exposure to tuberculosis
• D. Liver function tests to assess risk for medication toxicity

Correct answer: A

Rationale: Before starting Calcitonin-salmon, it is important to assess for any potential allergies as anaphylaxis can occur. A skin test is usually conducted to determine if the client is allergic to the medication. The nurse should also inquire about any previous allergies to fish, as Calcitonin-salmon is derived from salmon. Options B, C, and D are not necessary before initiating Calcitonin-salmon therapy. ECG is not directly related to this medication, Mantoux test is used to diagnose tuberculosis, and liver function tests are not specifically required before starting Calcitonin-salmon.

4. A client with breast cancer is being taught about Tamoxifen. Which of the following adverse effects of tamoxifen should the client be informed about?

• A. Irregular heart rhythm
• B. Abnormal uterine bleeding
• C. Yellowing of the sclera or dark-colored urine
• D. Difficulty swallowing

Correct answer: B

Rationale: Abnormal uterine bleeding is a known adverse effect of tamoxifen. It is important to educate the client about this side effect as those taking tamoxifen are at an increased risk for endometrial cancer. Any abnormal uterine bleeding should be promptly reported and evaluated by healthcare providers to ensure timely management and monitoring. The other options, such as irregular heart rhythm, yellowing of the sclera or dark-colored urine, and difficulty swallowing, are not typically associated with tamoxifen use and are not commonly reported adverse effects. Therefore, they are not the priority adverse effects to inform the client about.

5. A healthcare professional is preparing to administer heparin 15,000 units subcutaneously every 12 hours. The available heparin injection is 20,000 units/mL. How many milliliters should the healthcare professional administer per dose?

• A. 0.8 mL
• B. 0.75 mL
• C. 0.5 mL
• D. 1 mL

Correct answer: A

Rationale: To calculate the volume to administer, use the formula: Desired dose / Concentration = Volume to administer. In this case, (15,000 units / 20,000 units/mL) = 0.75 mL. Since the volume needs to be rounded up to the nearest tenth, the correct answer is 0.8 mL. Choice B (0.75 mL) is incorrect because it does not account for rounding up the volume. Choices C (0.5 mL) and D (1 mL) are incorrect as they do not reflect the precise calculation based on the given concentration and desired dose.

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