Which medication order requires nursing judgment and means administer if needed?
- A. Morphine 4 mg IV stat
- B. Morphine 4 mg IV prior to procedure
- C. Morphine 4 mg IV four times a day
- D. Morphine 4 mg IV every 4 hours PRN
Correct Answer: D
Rationale: PRN indicates for the nurse to administer morphine every 4 hours if needed and requires nursing judgment. Stat means the dose of morphine would be given immediately, not as needed. The orders for the dose of morphine to be given prior to the patient's scheduled procedure and four times a day, do not indicate to give the dose as needed.
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Frusemide is:
- A. A loop diuretic
- B. Osmotic diuretic
- C. Aldosterone antagonist
- D. A carbonic anhydrase inhibitor
Correct Answer: A
Rationale: Furosemide (Frusemide) is a loop diuretic that inhibits sodium and chloride reabsorption in the loop of Henle, leading to increased urine output.
Patient education when prescribing colchicine includes:
- A. Colchicine may be constipating
- B. Colchicine always causes some degree of diarrhea
- C. Mild muscle weakness is normal
- D. Moderate amounts of alcohol are safe with colchicine
Correct Answer: B
Rationale: Colchicine commonly causes diarrhea, not constipation ; weakness or alcohol aren't typical advice.
The FDA issued a safety announcement regarding the use of erythropoiesis-stimulating agents (ESAs) in 2010 with the recommendation that:
- A. ESAs no longer be prescribed to patients with chronic renal failure
- B. The risk of tumor development be explained to cancer patients on ESA therapy
- C. Patients should no longer receive ESA therapy to prepare for allogenic transfusions
- D. ESAs be prescribed only to patients staying
Correct Answer: B
Rationale: The 2010 FDA warning highlighted tumor progression risks in cancer patients on ESAs; renal use continues with caution.
While receiving treatment for kidney stones, a man complains of swelling and pain in his big toe and is found to have hyperuricemia
- A. Clomiphene
- B. Hydrochlorothiazide
- C. Furosemide
- D. Mifepristone
Correct Answer: B
Rationale: Thiazides like hydrochlorothiazide reduce uric acid excretion, causing hyperuricemia and gout.
A nurse is assisting with caring for a client with cancer who is receiving cisplatin. Select the adverse effects that the nurse monitors for that are associated with this medication. (Select one that does not apply.)
- A. Tinnitus
- B. Ototoxicity
- C. Hyperkalemia
- D. Hypomagnesemia
Correct Answer: C
Rationale: Cisplatin is an alkylating medication. Alkylating medications are cell cycle phase-nonspecific medications that affect the synthesis of DNA by causing the cross-linking of DNA to inhibit cell reproduction. Cisplatin may cause ototoxicity, tinnitus, hypokalemia, hypocalcemia, hypomagnesemia, and nephrotoxicity. Amifostine (Ethyol) may be administered before cisplatin to reduce the potential for renal toxicity. Correct answers include: 1 (Tinnitus), 2 (Ototoxicity), 5 (Nephrotoxicity), 6 (Hypomagnesemia).
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