Nursing Elites

1. A client is prescribed digoxin for heart failure. Which of the following should the nurse monitor to evaluate the effectiveness of the medication?

• A. Respiratory rate
• B. Blood pressure
• C. Apical pulse
• D. Urine output

Correct answer: C

Rationale: The correct answer is C: Apical pulse. Digoxin's primary effect is to strengthen the force of the heart's contractions and slow the heart rate. Monitoring the apical pulse is crucial in evaluating the effectiveness of digoxin as it helps assess the medication's impact on the heart's function. Option A, respiratory rate, is not directly related to digoxin's mechanism of action and is not the most appropriate parameter to monitor for this medication. Option B, blood pressure, while important, may not be as sensitive as the apical pulse in assessing the effectiveness of digoxin. Option D, urine output, is more indicative of kidney function and fluid balance, rather than the direct effectiveness of digoxin in heart failure.

2. A client is being educated about the use of spironolactone. Which of the following should be included in the teaching?

• A. Avoid potassium-rich foods
• B. Take the medication with food
• C. Monitor for signs of toxicity
• D. Discontinue the medication if potassium levels rise

Correct answer: A

Rationale: The correct answer is A: Avoid potassium-rich foods. Spironolactone can lead to hyperkalemia, a condition characterized by high levels of potassium in the blood. To prevent this complication, clients taking spironolactone should avoid potassium-rich foods. Choice B is incorrect because spironolactone can be taken with or without food. Choice C is not directly related to spironolactone use, as toxicity monitoring is not a specific concern with this medication. Choice D is incorrect because discontinuing the medication solely based on elevated potassium levels may not be necessary; instead, dosage adjustments or potassium restriction are often more appropriate.

3. A nurse is planning care for a client with a sealed radiation implant. Which intervention should the nurse implement?

• A. Remove dirty linens after double-bagging them
• B. Wear a dosimeter badge in the client’s room
• C. Limit visitors to 1 hour per day
• D. Ensure family remains 3 feet away from the client

Correct answer: B

Rationale: The nurse should wear a dosimeter badge to monitor radiation exposure when caring for a client with a sealed radiation implant.

4. A nurse is caring for a client prescribed clopidogrel. Which of the following should the nurse monitor?

• A. Liver function tests
• B. Blood pressure
• C. Potassium levels
• D. Respiratory rate

Correct answer: A

Rationale: Corrected Rationale: Clopidogrel is an antiplatelet medication, so the nurse should monitor for signs of bleeding and liver function tests due to potential liver effects. Monitoring liver function tests is essential to detect any adverse effects on the liver because clopidogrel can cause hepatotoxicity. While monitoring blood pressure, potassium levels, and respiratory rate are important in general patient care, they are not the priority assessments specifically related to clopidogrel use.

5. A nurse is caring for a client 4 hours postoperative following a thyroidectomy who reports fullness in the throat. What should the nurse assess for?

• A. Hypocalcemia
• B. Hemorrhage
• C. Hypoxia
• D. Hypothyroidism

Correct answer: B

Rationale: Fullness in the throat after a thyroidectomy could indicate bleeding or a hematoma, which can compress the airway, so hemorrhage is the priority concern. Hypocalcemia typically presents with symptoms like tingling around the mouth or in the extremities, muscle cramps, or seizures, not fullness in the throat. Hypoxia would manifest with symptoms like shortness of breath, confusion, or cyanosis, rather than a feeling of fullness in the throat. Hypothyroidism symptoms include fatigue, weight gain, and cold intolerance, but it does not typically cause acute fullness in the throat postoperatively.

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