Nursing Elites

1. A client has a new prescription for Digoxin to treat heart failure. Which of the following instructions should the nurse include in the teaching?

• A. Contact provider if heart rate is less than 60/min.
• B. Check pulse rate for 30 seconds and multiply the result by 2.
• C. Increase intake of sodium.
• D. Take with food if nausea occurs.

Correct answer: A

Rationale: The correct instruction for a client prescribed Digoxin for heart failure is to contact the provider if the heart rate is less than 60/min. Digoxin can affect heart rate, and a heart rate below 60/min may indicate toxicity, requiring prompt medical attention. Checking the pulse rate accurately and seeking medical advice are essential components of safe medication management. Choices B, C, and D are incorrect. Choice B is related to checking the pulse rate but does not address the critical action of contacting the provider if it is below 60/min. Increasing intake of sodium (Choice C) is inappropriate as high sodium levels can worsen heart failure. Taking Digoxin with food if nausea occurs (Choice D) does not address a critical aspect of Digoxin administration related to heart rate monitoring.

2. A client has a new prescription for alendronate to treat osteoporosis. Which of the following instructions should be included in the teaching?

• A. Take the medication with a full glass of water after rising in the morning.
• B. Lie down for 30 minutes after taking the medication.
• C. Take the medication with a meal to reduce gastric irritation.
• D. Crush the tablet and mix it with applesauce if difficulty swallowing.

Correct answer: A

Rationale: The correct instruction for taking alendronate is to take it with a full glass of water after rising in the morning to prevent esophageal irritation. It is important to remain upright for at least 30 minutes after taking the medication to reduce the risk of esophageal irritation and ensure proper absorption. Taking the medication with a meal or crushing the tablet are not recommended instructions for alendronate administration. Choice A is the correct answer as it aligns with the proper administration guidelines for alendronate.

3. A healthcare professional is preparing to initiate IV therapy for an older adult client. Which of the following actions should the professional plan to take?

• A. Use a blood pressure cuff to distend the veins.
• B. Select the antecubital area to insert the IV catheter.
• C. Distend the veins by using a blood pressure cuff.
• D. Direct the client to lower his arm below his heart.

Correct answer: C

Rationale: The correct answer is C. The healthcare professional should distend the veins using a blood pressure cuff to make the veins more visible and accessible for IV catheter insertion. This technique helps reduce the risk of overfilling the vein, which can lead to complications such as hematoma formation. Choices A, B, and D are incorrect because while selecting the antecubital area is often appropriate for IV insertion in adults, the key action in this scenario is to distend the veins using a blood pressure cuff to facilitate the procedure.

4. A client is receiving treatment with bevacizumab. Which of the following findings should the nurse monitor?

• A. Hypertension
• B. Hypokalemia
• C. Hyperglycemia
• D. Hypocalcemia

Correct answer: A

Rationale: Correct Answer: A. Bevacizumab is known to cause hypertension as a common adverse effect. The nurse should closely monitor the client's blood pressure to detect and manage this potential side effect promptly. Choice B, hypokalemia, is not typically associated with bevacizumab treatment. Choice C, hyperglycemia, is not a common adverse effect of bevacizumab. Choice D, hypocalcemia, is not a recognized side effect of bevacizumab.

5. What is the action of Metformin?

• A. Decreasing intestinal glucose absorption
• B. Increasing sensitivity to insulin
• C. Decreasing hepatic glucose production
• D. All of the above

Correct answer: D

Rationale: Metformin exerts its effects by decreasing hepatic glucose production, increasing sensitivity to insulin, and decreasing intestinal glucose absorption. These actions help in lowering blood glucose levels and improving insulin sensitivity in individuals with diabetes.

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