Nursing Elites

1. A healthcare professional prepares to administer sodium polystyrene sulfonate (Kayexalate) to a client. Before administering the medication, the professional reviews the action of the medication and understands that it:

• A. Releases bicarbonate in exchange for primarily sodium ions
• B. Releases sodium ions in exchange for primarily potassium ions
• C. Releases potassium ions in exchange for primarily sodium ions
• D. Releases sodium ions in exchange for primarily bicarbonate ions

Correct answer: B

Rationale: Sodium polystyrene sulfonate, such as Kayexalate, is a cation exchange resin that functions by releasing sodium ions in exchange for primarily potassium ions. This medication is commonly used to treat hyperkalemia, a condition characterized by elevated levels of potassium in the blood.

2. The client with squamous cell carcinoma of the larynx is receiving bleomycin intravenously. The nurse caring for the client anticipates that which diagnostic study will be prescribed?

• A. Echocardiography
• B. Electrocardiography
• C. Cervical radiography
• D. Pulmonary function studies

Correct answer: D

Rationale: Bleomycin, when administered intravenously, can lead to interstitial pneumonitis and potentially progress to pulmonary fibrosis. Therefore, pulmonary function studies are essential to monitor lung function and detect any early signs of pulmonary toxicity. Other tests, such as regular pulmonary assessments, should also be conducted to ensure the safety and well-being of the client.

3. Cycloserine (Seromycin) is added to the medication regimen for a client with tuberculosis. Which of the following would the nurse include in the client-teaching plan regarding this medication?

• A. To take the medication after meals
• B. To return to the clinic weekly for serum drug-level testing
• C. To call the health care provider (HCP) if a skin rash occurs
• D. To restrict alcohol intake with this medication

Correct answer: B

Rationale: Cycloserine requires weekly serum drug level determinations to monitor for neurotoxicity. The medication must be taken after meals, and the client should avoid alcohol. Additionally, the client should report any signs of skin rash or central nervous system toxicity to the healthcare provider.

4. After administering acetylcysteine (Mucomyst), 20% solution diluted in 0.9% normal saline by nebulizer, the nurse should have which item available for potential use?

• A. Ambu bag
• B. Intubation tray
• C. Nasogastric tube
• D. Suction equipment

Correct answer: D

Rationale: Acetylcysteine is administered via inhalation as a mucolytic. It helps liquefy secretions, making it easier for the client to clear them. However, in some cases, the increased volume of liquefied secretions may be challenging for the client to manage, leading to the potential need for suction equipment to assist in clearing the airway. Therefore, the nurse should have suction equipment available after administering acetylcysteine to address any issues related to excessive secretions.

5. A client with type 2 diabetes mellitus is prescribed glipizide (Glucotrol). Which instruction should the nurse include in the teaching plan?

• A. Take the medication before a meal.
• B. Monitor for signs of hypoglycemia.
• C. Avoid alcohol consumption while taking this medication.
• D. Take the medication before bedtime.

Correct answer: B

Rationale: The correct instruction the nurse should include in the teaching plan for a client prescribed glipizide (Glucotrol) is to monitor for signs of hypoglycemia. Glipizide stimulates insulin release from the pancreas, which can lead to hypoglycemia. It is usually taken before a meal, not necessarily on an empty stomach. Alcohol consumption should be avoided to prevent interactions with the medication. Taking the medication before bedtime is not the typical recommendation.

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