Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A. Exceeding the lifetime cumulative dose limit of doxorubicin might cause extravasation.
This is incorrect because extravasation is not related to the lifetime cumulative dose limit of doxorubicin, but to the leakage of the medication from the vein into the surrounding tissue. Extravasation can cause severe tissue damage and necrosis, and should be prevented by using a central venous catheter and monitoring the infusion site.
B. Exceeding the lifetime cumulative dose limit of doxorubicin might produce red tinged urine and sweat.
This is incorrect because red tinged urine and sweat are not related to the lifetime cumulative dose limit of doxorubicin, but to the normal excretion of the medication from the body. Red tinged urine and sweat are expected side effects of doxorubicin and do not indicate toxicity or harm.
C. An excess amount of doxorubicin can lead to cardiomyopathy.
This is correct because an excess amount of doxorubicin can lead to cardiomyopathy, which is a serious and potentially fatal complication of the medication. Cardiomyopathy is a condition in which the heart muscle becomes weak and unable to pump blood effectively. The risk of cardiomyopathy increases with the cumulative lifetime dose of doxorubicin, which should not exceed 450 to 550 mg/m2.
D. An excess amount of doxorubicin can lead to myelosuppression.
This is incorrect because myelosuppression is not related to the lifetime cumulative dose limit of doxorubicin, but to the dose-dependent effect of the medication on the bone marrow. Myelosuppression is a condition in which the production of blood cells is reduced, leading to anemia, leukopenia, and thrombocytopenia. Myelosuppression can be managed by adjusting the dose and frequency of doxorubicin and monitoring the blood counts.
This question is an excerpt from Nurse Dive's nursing test bank - Ati Pharmacology Proctored Exam 2. Take the full exam now
Full Explanation
Choice A reason: This is incorrect because extravasation is not related to the lifetime cumulative dose limit of doxorubicin, but to the leakage of the medication from the vein into the surrounding tissue. Extravasation can cause severe tissue damage and necrosis, and should be prevented by using a central venous catheter and monitoring the infusion site.
Choice B reason: This is incorrect because red tinged urine and sweat are not related to the lifetime cumulative dose limit of doxorubicin, but to the normal excretion of the medication from the body. Red tinged urine and sweat are expected side effects of doxorubicin and do not indicate toxicity or harm.
Choice C reason: This is correct because an excess amount of doxorubicin can lead to cardiomyopathy, which is a serious and potentially fatal complication of the medication. Cardiomyopathy is a condition in which the heart muscle becomes weak and unable to pump blood effectively. The risk of cardiomyopathy increases with the cumulative lifetime dose of doxorubicin, which should not exceed 450 to 550 mg/m2.
Choice D reason: This is incorrect because myelosuppression is not related to the lifetime cumulative dose limit of doxorubicin, but to the dose-dependent effect of the medication on the bone marrow. Myelosuppression is a condition in which the production of blood cells is reduced, leading to anemia, leukopenia, and thrombocytopenia. Myelosuppression can be managed by adjusting the dose and frequency of doxorubicin and monitoring the blood counts.
Similar Questions
A nurse is caring for a client who is to receive a unit of packed RBCs. The nurse should prime the blood administration tubing using which of the following IV solutions?
A. Dextrose 5% in 0.45% sodium chloride
This is incorrect because dextrose 5% in 0.45% sodium chloride is a hypotonic solution that can cause hemolysis of the RBCs. It can also cause fluid shifts from the intravascular to the intracellular space, leading to edema and hypotension.
B. 0.9% sodium chloride
This is correct because 0.9% sodium chloride is a isotonic solution that is compatible with blood products. It does not cause hemolysis or fluid shifts and maintains the osmotic pressure of the blood.
C. Lactated Ringer's solution
This is incorrect because lactated Ringer's solution is a isotonic solution that contains electrolytes, such as potassium, calcium, and lactate, that can interfere with the blood products. It can also cause metabolic alkalosis due to the conversion of lactate to bicarbonate.
D. Dextrose 5% in water
This is incorrect because dextrose 5% in water is a hypotonic solution that can cause hemolysis of the RBCs. It can also cause fluid shifts from the intravascular to the intracellular space, leading to edema and hypotension.
Full Explanation
Choice A reason: This is incorrect because dextrose 5% in 0.45% sodium chloride is a hypotonic solution that can cause hemolysis of the RBCs. It can also cause fluid shifts from the intravascular to the intracellular space, leading to edema and hypotension.
Choice B reason: This is correct because 0.9% sodium chloride is a isotonic solution that is compatible with blood products. It does not cause hemolysis or fluid shifts and maintains the osmotic pressure of the blood.
Choice C reason: This is incorrect because lactated Ringer's solution is a isotonic solution that contains electrolytes, such as potassium, calcium, and lactate, that can interfere with the blood products. It can also cause metabolic alkalosis due to the conversion of lactate to bicarbonate.
Choice D reason: This is incorrect because dextrose 5% in water is a hypotonic solution that can cause hemolysis of the RBCs. It can also cause fluid shifts from the intravascular to the intracellular space, leading to edema and hypotension.
A nurse is caring for a client who is postoperative following hip arthroplasty. The nurse should anticipate which of the following medications for this client?
A. Aspirin
This is incorrect because aspirin is not a suitable medication for preventing venous thromboembolism (VTE) in a client who is postoperative following hip arthroplasty. Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that has antiplatelet and analgesic effects, but it is not as effective as anticoagulants for VTE prophylaxis.
B. Alteplase
This is incorrect because alteplase is not a medication for preventing VTE, but for treating it. Alteplase is a thrombolytic agent that dissolves existing blood clots by activating plasminogen. It is used for acute ischemic stroke, myocardial infarction, and massive pulmonary embolism, but it has a high risk of bleeding and is contraindicated in clients who have had recent surgery.
C. Clopidogrel
This is incorrect because clopidogrel is not a medication for preventing VTE, but for preventing arterial thrombosis. Clopidogrel is an antiplatelet agent that inhibits the adenosine diphosphate (ADP) receptor on platelets, preventing their aggregation. It is used for clients who have had acute coronary syndrome, percutaneous coronary intervention, or ischemic stroke, but it is not effective for VTE prophylaxis.
D. Enoxaparin
This is correct because enoxaparin is a medication for preventing VTE in a client who is postoperative following hip arthroplasty. Enoxaparin is a low molecular weight heparin (LMWH) that inhibits factor Xa and thrombin, preventing the formation of fibrin. It is administered subcutaneously once or twice daily and does not require routine laboratory monitoring. It has a lower risk of bleeding and heparin-induced thrombocytopenia (HIT) than unfractionated heparin.
Full Explanation
Choice A reason: This is incorrect because aspirin is not a suitable medication for preventing venous thromboembolism (VTE) in a client who is postoperative following hip arthroplasty. Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that has antiplatelet and analgesic effects, but it is not as effective as anticoagulants for VTE prophylaxis.
Choice B reason: This is incorrect because alteplase is not a medication for preventing VTE, but for treating it. Alteplase is a thrombolytic agent that dissolves existing blood clots by activating plasminogen. It is used for acute ischemic stroke, myocardial infarction, and massive pulmonary embolism, but it has a high risk of bleeding and is contraindicated in clients who have had recent surgery.
Choice C reason: This is incorrect because clopidogrel is not a medication for preventing VTE, but for preventing arterial thrombosis. Clopidogrel is an antiplatelet agent that inhibits the adenosine diphosphate (ADP) receptor on platelets, preventing their aggregation. It is used for clients who have had acute coronary syndrome, percutaneous coronary intervention, or ischemic stroke, but it is not effective for VTE prophylaxis.
Choice D reason: This is correct because enoxaparin is a medication for preventing VTE in a client who is postoperative following hip arthroplasty. Enoxaparin is a low molecular weight heparin (LMWH) that inhibits factor Xa and thrombin, preventing the formation of fibrin. It is administered subcutaneously once or twice daily and does not require routine laboratory monitoring. It has a lower risk of bleeding and heparin-induced thrombocytopenia (HIT) than unfractionated heparin.
A nurse is reviewing the medical record of a client who has hypertension and a new prescription for metoprolol. Which of the following findings should the nurse investigate further?
A. A history of left-sided heart failure
This is not a problem for a client who has hypertension and a new prescription for metoprolol, as metoprolol is a beta-blocker that can reduce the workload of the heart and improve the symptoms of heart failure.
B. Recently treated bilateral pneumonia
This is not a problem for a client who has hypertension and a new prescription for metoprolol, as metoprolol does not have any significant interactions with antibiotics or other medications used to treat pneumonia.
C. A concurrent prescription for tadalafil
This is a problem for a client who has hypertension and a new prescription for metoprolol, as tadalafil is a phosphodiesterase-5 inhibitor that can lower the blood pressure and cause hypotension when taken with metoprolol. The nurse should investigate further and notify the provider of the potential interaction.
D. Diet-controlled Type 2 diabetes mellitus
This is not a problem for a client who has hypertension and a new prescription for metoprolol, as metoprolol does not affect the blood glucose levels or the management of diabetes.
Full Explanation
Choice A reason: This is not a problem for a client who has hypertension and a new prescription for metoprolol, as metoprolol is a beta-blocker that can reduce the workload of the heart and improve the symptoms of heart failure.
Choice B reason: This is not a problem for a client who has hypertension and a new prescription for metoprolol, as metoprolol does not have any significant interactions with antibiotics or other medications used to treat pneumonia.
Choice C reason: This is a problem for a client who has hypertension and a new prescription for metoprolol, as tadalafil is a phosphodiesterase-5 inhibitor that can lower the blood pressure and cause hypotension when taken with metoprolol. The nurse should investigate further and notify the provider of the potential interaction.
Choice D reason: This is not a problem for a client who has hypertension and a new prescription for metoprolol, as metoprolol does not affect the blood glucose levels or the management of diabetes.