Nursing Elites

1. When administering the drug senna to a patient, what must a health care provider inform the patient of?

• A. This drug is intended to lower blood pressure and is best used in combination with other antihypertensives
• B. This drug is not intended for long-term use
• C. The patient must limit his/her fiber intake
• D. Advise the patient to change positions slowly to limit the risk of orthostatic hypotension

Correct answer: B

Rationale: The correct answer is B. Senna is a laxative used for short-term relief of constipation, not for long-term use. Choice A is incorrect because senna does not lower blood pressure or require combination with antihypertensives. Choice C is unrelated as there is no need to limit fiber intake with senna. Choice D is incorrect as orthostatic hypotension is not a common concern with senna use.

2. During a unit of whole blood transfusion, a client develops a cough, shortness of breath, elevated blood pressure, and distended neck veins. The healthcare professional should anticipate a prescription for which of the following medications?

• A. Epinephrine
• B. Lorazepam
• C. Furosemide
• D. Diphenhydramine

Correct answer: C

Rationale: In the scenario described, the client is exhibiting signs of fluid overload, which can occur during blood transfusion. Furosemide, a loop diuretic, is commonly prescribed in such situations to help relieve manifestations of circulatory overload by promoting diuresis and reducing fluid volume. Therefore, the correct choice is C - Furosemide. Epinephrine (Choice A) is not indicated for fluid overload but for severe allergic reactions. Lorazepam (Choice B) is a benzodiazepine used for anxiety or sedation, not for fluid overload. Diphenhydramine (Choice D) is an antihistamine often used for allergic reactions, not for fluid overload.

3. A client with breast cancer is receiving cyclophosphamide. What finding should the nurse monitor for?

• A. Hypertension
• B. Hyperglycemia
• C. Ototoxicity
• D. Hemorrhagic cystitis

Correct answer: D

Rationale: When a client is receiving cyclophosphamide, the nurse should monitor for hemorrhagic cystitis, a severe adverse effect caused by bladder irritation. It is essential to watch for signs such as hematuria, dysuria, and urinary frequency, and promptly intervene to prevent further complications. Hypertension (Choice A) is not typically associated with cyclophosphamide use. Hyperglycemia (Choice B) is not a common side effect of cyclophosphamide. Ototoxicity (Choice C) is more commonly associated with medications like aminoglycoside antibiotics or high-dose aspirin.

4. Which of the following conditions is not treated with Methotrexate?

• A. Sarcomas
• B. Leukemias
• C. Ectopic pregnancy
• D. Rheumatic fever

Correct answer: D

Rationale: The correct answer is D. Methotrexate is not typically used to treat rheumatic fever, which is more commonly managed with antibiotics to eradicate the underlying infection. Methotrexate is commonly used in the treatment of conditions like sarcomas, leukemias, and ectopic pregnancies due to its anti-inflammatory and anti-cancer properties.

5. A healthcare professional is preparing to administer Filgrastim for the first time to a client who has just undergone a bone marrow transplant. Which of the following interventions is appropriate?

• A. Administer subcutaneously in a large muscle mass to prevent injury.
• B. Ensure that the medication is kept at room temperature until just prior to administration.
• C. Invert vial gently to mix well before withdrawing dose.
• D. Discard vial after removing one dose of the medication.

Correct answer: D

Rationale: The correct intervention when preparing to administer Filgrastim is to discard the vial after removing one dose of the medication. This practice helps prevent contamination and ensures the medication's effectiveness. Reusing the vial can lead to contamination and compromise the sterility of the medication, putting the client at risk. Therefore, it is crucial to follow proper aseptic technique and discard the vial after withdrawing the prescribed dose.

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