Nursing Elites

1. Why is it important to monitor ins and outs in patients using ACE inhibitors?

• A. To assess for renal impairment
• B. To ensure the patient is receiving adequate fluid intake
• C. To assess the patient for potential heart failure
• D. To assess for NSAID use

Correct answer: A

Rationale: It is crucial to monitor ins and outs in patients using ACE inhibitors to assess for renal impairment. ACE inhibitors can affect renal function, potentially leading to renal impairment. Monitoring the patient's fluid balance helps in early recognition of any renal issues and allows for timely interventions to prevent complications.

2. A client is starting therapy with filgrastim. Which of the following adverse effects should the nurse instruct the client to monitor?

• A. Bone pain
• B. Constipation
• C. Tinnitus
• D. Dry mouth

Correct answer: A

Rationale: When a client is starting therapy with filgrastim, monitoring for bone pain is essential. Filgrastim can lead to increased bone marrow activity, resulting in bone pain as a common adverse effect. Instructing the client to monitor and report any bone pain promptly can help in managing this side effect effectively.

3. A healthcare professional is caring for a young adult client with a serum calcium level of 8.8 mg/dL. Which of the following medications should the professional anticipate administering to this client?

• A. Calcitonin-salmon
• B. Calcium carbonate
• C. Zoledronic acid
• D. Ibandronate

Correct answer: B

Rationale: The client's serum calcium level is below the expected reference range, indicating hypocalcemia. Calcium carbonate, an oral form of calcium, is used to increase serum calcium levels to the expected range in cases of hypocalcemia. It helps correct the deficiency by supplementing calcium in the body.

4. A client has a new prescription for Raltegravir. Which of the following statements should the nurse include in teaching the client?

• A. This medication prevents the virus from entering the cell.
• B. This medication prevents the virus from leaving the cell.
• C. This medication blocks the virus from attaching to the cell.
• D. This medication blocks the virus from replicating in the cell.

Correct answer: D

Rationale: The correct answer is D because Raltegravir works by blocking the integrase enzyme, preventing the virus from integrating its genetic material into the host cell's DNA. By inhibiting this process, viral replication within the host cell is halted. Choices A, B, and C are incorrect because Raltegravir's mechanism of action specifically targets viral replication within the cell, not virus entry, exit, or attachment to the cell.

5. A client is prescribed an IM dose of penicillin. The client reports developing a rash after taking penicillin 3 years ago. What should the nurse do?

• A. Administer the prescribed dose.
• B. Withhold the medication.
• C. Ask the provider to change the prescription to an oral form.
• D. Administer an oral antihistamine at the same time.

Correct answer: B

Rationale: The nurse should withhold the medication and inform the provider of the client's previous rash after taking penicillin. This history suggests a potential allergic reaction to penicillin, which can range from mild to severe anaphylaxis. Notifying the provider allows for an alternative antibiotic to be prescribed, considering the client's allergy to penicillin. It is crucial to avoid administering a medication that could potentially lead to a severe allergic reaction in the client. Administering the prescribed dose (Choice A) could be harmful due to the potential for an allergic reaction. Changing the prescription to an oral form (Choice C) does not address the underlying issue of a potential penicillin allergy. Administering an oral antihistamine (Choice D) without consulting the provider may not be sufficient to prevent a severe allergic reaction.

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