Nokea
The newly licensed nurse is preparing to administer a high dose of androgen to the female client. The nurse manager asks for the rationale. What is the best response by the new nurse?
- A. My client wants to improve athletic performance
- B. My client has breast cancer
- C. My client has brain cancer
- D. My client is planning on sexual reassignment surgery
Correct Answer: B
Rationale: High-dose androgen therapy in females is occasionally used as a palliative treatment for certain breast cancers, particularly hormone-sensitive types, where it suppresses estrogen-driven tumor growth, offering symptom relief in advanced stages. Using androgens for athletic performance enhancement, while possible due to their anabolic effects, isn't a clinical indication and is illegal in regulated settings. Brain cancer lacks evidence supporting androgen use, as it doesn't target neurological malignancies. Sexual reassignment involves testosterone for masculinization, but high doses in a clinical context typically align with cancer care, not transition protocols. The breast cancer rationale reflects a recognized, albeit niche, therapeutic use, leveraging androgens' anti-estrogenic properties to slow disease progression, making it the most defensible clinical justification in this scenario.
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A client with thrombophlebitis receiving heparin by continuous IV infusion asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses should the nurse give?
- A. It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level.
- B. A pharmacist is the person to answer that question.
- C. Heparin does not dissolve clots. It stops new clots from forming.
- D. The oral medication you will take after this IV will dissolve the clot.
Correct Answer: C
Rationale: The correct response is C. Heparin does not dissolve clots; it prevents new clots from forming. Heparin works by inhibiting the formation of new clots and the extension of existing clots, rather than directly dissolving them. The client should be informed that the purpose of heparin therapy is to prevent the clot from getting larger and to reduce the risk of new clots forming. Choices A, B, and D are incorrect. Choice A talks about reaching a therapeutic blood level of heparin, which is not related to clot dissolution. Choice B deflects the question to a pharmacist without providing relevant information. Choice D inaccurately suggests that an oral medication will dissolve the clot, which is not the mechanism of action for heparin.
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.
When educating a client starting a new prescription for metoprolol, which instruction should the nurse include?
- A. Check your pulse before taking the medication.
- B. Take the medication with food to increase absorption.
- C. Avoid sudden changes in position.
- D. Monitor your blood pressure regularly.
Correct Answer: C
Rationale: The correct instruction for a client starting metoprolol is to avoid sudden changes in position. Metoprolol can cause dizziness due to its blood pressure-lowering effects, increasing the risk of falls and injury. Instructing the client to change positions slowly helps prevent orthostatic hypotension and related adverse events. Checking the pulse before taking the medication (Choice A) is not typically necessary for metoprolol. Taking the medication with food (Choice B) is not required for absorption and can be taken with or without food. Monitoring blood pressure regularly (Choice D) is essential for clients taking metoprolol, but avoiding sudden changes in position is more critical to prevent dizziness and falls.
A healthcare professional is about to administer Propranolol to a patient. The healthcare professional takes the patient's apical pulse and documents it as 58 bpm. How should the healthcare professional proceed?
- A. Administer the medication as prescribed
- B. Administer half of the normal dose
- C. Consider the extended-release form of the medication
- D. Withhold administration of the medication and notify the healthcare provider
Correct Answer: D
Rationale: When a patient's apical pulse is 58 bpm, it is below the normal range. Propranolol is a beta-blocker that can further lower the heart rate. Therefore, it is crucial to withhold the medication and notify the healthcare provider to evaluate the patient's condition. Administering Propranolol in this situation can exacerbate bradycardia, leading to serious complications. Choosing to administer the medication as prescribed (Choice A) can put the patient at risk. Administering half of the normal dose (Choice B) without healthcare provider guidance is not appropriate in this case. Considering the extended-release form of the medication (Choice C) does not address the immediate concern of bradycardia and is not the best course of action.
A client with cancer and a prescription for methotrexate PO reports bleeding gums while being assessed by a nurse in a provider's clinic. Which of the following actions should the nurse take?
- A. Explain to the client that this is an expected adverse effect.
- B. Check the value of the client's current platelet count.
- C. Instruct the client to use an electric toothbrush.
- D. Have the client make an appointment to see the dentist.
Correct Answer: B
Rationale: The correct action for the nurse to take when a client on methotrexate reports bleeding gums is to check the client's current platelet count. Bleeding gums may indicate thrombocytopenia, a decreased platelet count which can be a severe side effect of methotrexate therapy. Monitoring the platelet count is crucial for early detection and management of this potentially life-threatening complication. Choice A is incorrect as bleeding gums in this context may not be an expected adverse effect of methotrexate. Choice C is irrelevant and does not address the potential underlying issue of thrombocytopenia. Choice D is not the primary action needed at this point; checking the platelet count is more urgent to assess the severity of the situation.