Nursing Elites

1. A healthcare provider is reviewing a client's medical history and notes that the client has a prescription for Digoxin. Which of the following findings is a manifestation of Digoxin toxicity?

• A. Elevated blood pressure
• B. Bradycardia
• C. Yellow-tinged vision
• D. Ringing in the ears

Correct answer: C

Rationale: Yellow-tinged vision, along with nausea, vomiting, and confusion, are common manifestations of Digoxin toxicity. Visual disturbances are important to recognize as they can indicate the need for immediate medical attention and potential adjustment of Digoxin therapy to prevent serious complications. Elevated blood pressure is not typically associated with Digoxin toxicity; instead, hypotension may occur. Bradycardia is a common therapeutic effect of Digoxin rather than a sign of toxicity. Ringing in the ears, or tinnitus, is also a potential side effect of Digoxin but is less specific to toxicity compared to yellow-tinged vision.

2. A healthcare provider is educating a client who has a new prescription for Simvastatin. Which of the following instructions should the healthcare provider include?

• A. Take this medication with food.
• B. Avoid drinking grapefruit juice.
• C. Take this medication in the morning.
• D. Increase your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct instruction that the healthcare provider should include is to 'Avoid drinking grapefruit juice.' Grapefruit juice can increase the blood levels of Simvastatin, leading to potential side effects like muscle pain and liver damage. Instructing the client to avoid grapefruit juice helps prevent these adverse effects and ensures the medication's efficacy. Choices A, C, and D are incorrect because taking Simvastatin with food, at a specific time, or increasing potassium-rich foods intake are not essential instructions for this medication.

3. Which drug class has been found to decrease mortality if given within 8 hours of an MI due to a decrease in cardiac workload?

• A. Antiplatelets
• B. Beta-adrenergic blockers
• C. ACE inhibitors
• D. Calcium channel blockers

Correct answer: B

Rationale: Beta-adrenergic blockers have been shown to decrease mortality when administered within 8 hours of a myocardial infarction (MI). They do so by reducing cardiac workload, which helps improve outcomes post-MI. These drugs work by blocking the effects of adrenaline on the heart, leading to decreased heart rate, blood pressure, and myocardial oxygen demand, thereby protecting the heart muscle from further damage. This makes them a crucial part of the treatment regimen for acute coronary syndromes like MI.

4. A healthcare provider plans to administer Morphine IV to a postoperative client. Which of the following actions should the provider take?

• A. Monitor for seizures and confusion with repeated doses.
• B. Protect the client's skin from severe diarrhea associated with morphine.
• C. Withhold this medication if the respiratory rate is less than 12/min.
• D. Administer Morphine intermittently via IV bolus over 30 seconds or less.

Correct answer: C

Rationale: The correct action for the provider is to withhold morphine if the client's respiratory rate is 12/min or less. Respiratory depression is a serious side effect of morphine and other opioids. Withholding the medication and informing the healthcare provider is essential to prevent further respiratory compromise in the client. Choices A, B, and D are incorrect because monitoring for seizures and confusion, protecting the client's skin from severe diarrhea, and administering morphine via IV bolus over 30 seconds or less are not the primary actions to ensure client safety when administering morphine IV. Respiratory status is crucial due to the risk of respiratory depression associated with opioid administration.

5. A client has a new prescription for Ranitidine to treat peptic ulcer disease. Which of the following instructions should the nurse include?

• A. Take the medication on an empty stomach.
• B. Avoid smoking while taking this medication.
• C. Increase intake of dairy products.
• D. Expect a yellow tinge to the skin.

Correct answer: B

Rationale: The correct instruction that the nurse should include for a client prescribed Ranitidine to treat peptic ulcer disease is to avoid smoking while taking the medication. Smoking can interfere with the effectiveness of ranitidine and worsen ulcer symptoms. Therefore, it is crucial for clients to abstain from smoking to ensure optimal therapeutic outcomes. Choices A, C, and D are incorrect. Taking Ranitidine with or without food does not significantly affect its effectiveness, there is no specific need to increase intake of dairy products, and expecting a yellow tinge to the skin is not a common side effect associated with Ranitidine.

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