Nursing Elites

1. The clinic nurse is reviewing a teaching plan for a client receiving antineoplastic medication. When implementing the plan, the nurse should advise the client:

• A. To take aspirin (acetylsalicylic acid) as needed for a headache
• B. To avoid drinking beverages containing alcohol
• C. To consult with healthcare providers (HCPs) before receiving immunizations
• D. That it is necessary to consult HCPs before receiving a flu vaccine at the local health fair

Correct answer: C

Rationale: The correct advice for a client receiving antineoplastic medication is to consult with healthcare providers (HCPs) before receiving immunizations. Antineoplastic medications can lower the body's resistance, making it crucial to seek guidance from healthcare providers to prevent potential complications that may arise due to the medication's impact on the immune system. Choices A, B, and D are incorrect because taking aspirin for a headache, avoiding alcohol, and consulting only before a flu vaccine at a local health fair do not directly address the specific risk related to antineoplastic medications and immunizations.

2. Before administering Methylergonovine (Methergine) to a client with postpartum hemorrhage caused by uterine atony, the nurse checks which of the following as the important client parameter?

• A. Temperature
• B. Lochial flow
• C. Urine output
• D. Blood pressure

Correct answer: D

Rationale: Methylergonovine (Methergine) acts by stimulating uterine contractions and causing vasoconstriction. As vasoconstriction can potentially impact blood pressure, it is crucial to check the client's blood pressure before administering Methylergonovine to monitor for any hypertensive effects.

3. A client with chronic obstructive pulmonary disease (COPD) is prescribed tiotropium (Spiriva). Which instruction should the nurse include in the teaching plan?

• A. Use the medication as a rescue inhaler.
• B. Rinse your mouth after using the inhaler.
• C. Take the medication on an empty stomach.
• D. Take the medication with a full glass of water.

Correct answer: B

Rationale: Tiotropium (Spiriva) is not a rescue inhaler but a maintenance medication for COPD. The correct instruction for the nurse to include in the teaching plan is to advise the client to rinse their mouth after using the inhaler. This practice helps prevent dry mouth and throat irritation, common side effects of tiotropium. There are no specific recommendations to take tiotropium on an empty stomach or with a full glass of water.

4. A client receives a prescription for methocarbamol (Robaxin), and the nurse reinforces instructions to the client regarding the medication. Which client statement would indicate a need for further instructions?

• A. My urine may turn brown or green.
• B. This medication is prescribed to help relieve my muscle spasms.
• C. If my vision becomes blurred, I need to be concerned about it.
• D. I need to call my doctor if I experience nasal congestion from this medication.

Correct answer: C

Rationale: The correct answer is C because blurred vision is an adverse effect of methocarbamol (Robaxin) and should be reported to a healthcare provider. Choices A, B, and D are all correct statements. Option A informs the client about a possible discoloration of urine, which is a known side effect. Option B correctly explains the purpose of the medication. Option D correctly advises the client to contact their doctor if they experience nasal congestion, which could indicate an adverse reaction.

5. The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to the site of injury. The nurse monitors the client, knowing that which of the following indicates that a systemic effect has occurred?

• A. Hyperventilation
• B. Elevated blood pressure
• C. Local pain at the burn site
• D. Local rash at the burn site

Correct answer: A

Rationale: Hyperventilation is an indication of a systemic effect of mafenide acetate (Sulfamylon) due to its potential to cause acidosis by suppressing renal excretion of acid. If hyperventilation occurs, the medication should be discontinued to prevent further complications.

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