Nursing Elites

1. Before administering digoxin (Lanoxin) to a client diagnosed with heart failure, the nurse should perform which assessment?

• A. Check the blood pressure.
• B. Obtain an electrocardiogram (ECG).
• C. Assess the apical pulse.
• D. Review the latest electrolyte levels.

Correct answer: C

Rationale: Assessing the apical pulse is crucial before administering digoxin because the medication can lead to bradycardia. Monitoring the apical pulse helps determine the heart rate, and digoxin is typically withheld if the pulse is below 60 beats per minute. This assessment is essential to prevent potential adverse effects associated with digoxin administration. Checking the blood pressure (Choice A) is important but not specific to digoxin administration. Obtaining an electrocardiogram (ECG) (Choice B) may provide valuable information but is not the primary assessment needed before administering digoxin. Reviewing the latest electrolyte levels (Choice D) is important for assessing the overall condition but is not the immediate assessment required before administering digoxin.

2. A healthcare professional is assessing a client who has been taking isoniazid to treat tuberculosis. The healthcare professional should monitor the client for which of the following findings as an adverse effect of the medication?

• A. Diarrhea
• B. Blurred vision
• C. Hearing loss
• D. Jaundice

Correct answer: D

Rationale: Correct. Jaundice is a serious adverse effect of isoniazid due to liver damage. It is essential to monitor for signs of liver toxicity, such as jaundice, while the client is on this medication. Diarrhea is a common side effect of isoniazid, but it is not as serious as liver damage. Blurred vision and hearing loss are not typically associated with isoniazid use.

3. A client reports chest pain that is unrelieved by three doses of nitroglycerin taken 5 minutes apart. What is the nurse's next best action?

• A. Administer another dose of nitroglycerin.
• B. Call the healthcare provider immediately.
• C. Provide oxygen via nasal cannula.
• D. Place the client in a supine position.

Correct answer: B

Rationale: In the scenario described, the client's chest pain persists despite three doses of nitroglycerin, indicating a potentially severe cardiac issue like a myocardial infarction. The priority for the nurse in this situation is to involve the healthcare provider promptly. Calling the healthcare provider immediately is essential to ensure timely evaluation and appropriate intervention for the client. Administering more nitroglycerin without further assessment or instructions may not be safe and could delay necessary treatments. Providing oxygen or changing the client's position may offer some comfort but does not address the underlying potentially life-threatening condition, making these options less appropriate as the immediate next best action.

4. The nurse is caring for a client diagnosed with heart failure who is taking digoxin (Lanoxin). Which sign of digoxin toxicity should the nurse monitor for?

• A. Hypertension
• B. Bradycardia
• C. Hyperglycemia
• D. Insomnia

Correct answer: B

Rationale: The correct answer is B: Bradycardia. Bradycardia is a common sign of digoxin toxicity, as digoxin can cause decreased heart rate. Therefore, monitoring the client for signs of bradycardia is crucial. Choices A, C, and D are incorrect. Hypertension is not typically associated with digoxin toxicity; instead, hypotension may occur. Hyperglycemia is not a common sign of digoxin toxicity. Insomnia is also not a typical sign of digoxin toxicity; instead, some patients may experience visual disturbances, confusion, or other neurological symptoms.

5. The healthcare provider is preparing to administer a beta blocker to a client with hypertension. What parameter should be checked before administering the medication?

• A. Serum potassium level
• B. Apical pulse
• C. Oxygen saturation
• D. Pupil reaction to light

Correct answer: B

Rationale: Before administering a beta blocker, it is crucial to check the apical pulse. Beta blockers have the potential to slow down the heart rate, making it essential to assess the pulse rate to ensure it is within the safe range before giving the medication. Checking the serum potassium level (choice A) is important when administering certain medications, but it is not specifically required before giving a beta blocker. Oxygen saturation (choice C) and pupil reaction to light (choice D) are not directly related to monitoring parameters for beta blocker administration.

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