Nursing Elites

1. Why does a nurse on an oncology unit verify a client's current cumulative lifetime dose of doxorubicin before administering it to a client with breast cancer?

• A. Excessive doxorubicin can result in myelosuppression.
• B. Exceeding the lifetime cumulative dose limit of doxorubicin may lead to extravasation.
• C. An excess amount of doxorubicin can lead to cardiomyopathy.
• D. Exceeding the lifetime cumulative dose limit of doxorubicin may cause red-tinged urine and sweat.

Correct answer: C

Rationale: Verifying the client's current cumulative lifetime dose of doxorubicin is necessary because excessive amounts of the medication can lead to cardiomyopathy, a serious and potentially life-threatening side effect. By monitoring the cumulative dose, healthcare providers can help prevent cardiotoxicity and ensure patient safety during treatment.

2. A client has a prescription for Clonidine to treat hypertension. Which of the following instructions should the nurse include?

• A. Discontinue the medication if you experience dry mouth.
• B. Take the medication at the same time each day.
• C. Double the dose if you miss a dose.
• D. Avoid drinking orange juice while taking this medication.

Correct answer: B

Rationale: Correct Answer: Taking Clonidine at the same time each day is crucial to ensure consistent blood levels and effectively manage blood pressure. Consistency in timing helps optimize the medication's effectiveness in controlling hypertension.

3. When teaching a client with a new prescription for Ipratropium, which of the following instructions should the nurse include?

• A. This medication can be used as a rescue inhaler.
• B. This medication should be taken before albuterol.
• C. Wait 5 minutes between medications if two inhaled medications are prescribed.
• D. Ipratropium can be used before exercise.

Correct answer: C

Rationale: When two inhaled medications are prescribed, waiting 5 minutes between medications allows for optimal absorption and effectiveness of each medication. This ensures that each medication can work properly without interference from the other, improving the client's respiratory condition.

4. A client has a new prescription for Metformin to treat type 2 diabetes. Which of the following laboratory results should be monitored?

• A. Hemoglobin A1C
• B. Liver function tests
• C. Electrolyte levels
• D. Kidney function

Correct answer: D

Rationale: Metformin is excreted by the kidneys, and impaired kidney function can lead to an increased risk of lactic acidosis, a serious side effect. Therefore, it is important to monitor kidney function regularly while a client is on Metformin. Hemoglobin A1C is used to monitor long-term glucose control, but kidney function is the priority for monitoring Metformin therapy.

5. A client is prescribed Propranolol for dysrhythmia. Which action should the nurse plan to take?

• A. Hold Propranolol if the client's apical pulse is greater than 100/min.
• B. Monitor the client's blood pressure after administering Propranolol.
• C. Assist the client when transitioning to a sitting or standing position after taking Propranolol.
• D. Monitor the client's potassium levels for signs of Propranolol toxicity.

Correct answer: C

Rationale: The correct action the nurse should plan to take when administering Propranolol to a client with dysrhythmia is to assist the client when transitioning to a sitting or standing position. Propranolol can cause orthostatic hypotension, leading to dizziness during position changes, so it is essential to help the client move slowly to prevent falls or injuries. Choices A, B, and D are incorrect because holding Propranolol based on pulse rate, monitoring blood pressure after administration, and monitoring potassium levels are not directly related to the common side effect of orthostatic hypotension associated with Propranolol.

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