Nursing Elites

1. A client who is newly diagnosed with erosive esophagitis secondary to GERD experiences symptoms after taking lansoprazole PO for one full week. Which actions should the nurse take?

• A. Confirm that the client is taking the medication correctly
• B. Auscultate the client's bowel sounds and assess the apical pulse
• C. Advise the client that healing typically takes several weeks
• D. Notify the healthcare provider to consider a higher dose

Correct answer: C

Rationale: The correct action for the nurse to take in this situation is to advise the client that healing from erosive esophagitis typically takes several weeks. Providing this information helps manage the client's expectations and anxiety about treatment effectiveness. It is not necessary to confirm medication timing, assess bowel sounds, or measure the apical pulse at this point. Since symptoms persist after one week of lansoprazole, it may not be appropriate to immediately escalate to a higher dose without further assessment or guidance from the healthcare provider. Auscultating bowel sounds and assessing the apical pulse are not relevant to the client's symptoms related to erosive esophagitis and GERD.

2. A 6-month-old infant is prescribed digoxin for the treatment of congestive heart failure. Which observation by the practical nurse (PN) warrants immediate intervention for signs of digoxin toxicity?

• A. Apical heart rate of 60 beats/min
• B. Sweating across the forehead
• C. Poor sucking effort
• D. Respiratory rate of 30 breaths/min

Correct answer: A

Rationale: A heart rate of 60 beats/min for a 6-month-old infant warrants immediate intervention as it falls below the normal range. The normal heart rate for a 6-month-old is 80 to 150 beats/min when awake, and a rate of 70 beats/min while sleeping is considered within normal limits. Bradycardia (heart rate <60 beats/min) in infants can be a sign of digoxin toxicity, necessitating prompt evaluation and intervention to prevent adverse effects. Sweating across the forehead (Choice B) is a non-specific symptom and may not directly indicate digoxin toxicity. Poor sucking effort (Choice C) and a respiratory rate of 30 breaths/min (Choice D) are not typically associated with digoxin toxicity and do not require immediate intervention in the context of this question.

3. A client with a history of heart failure is prescribed carvedilol. The nurse should monitor the client for which adverse effect?

• A. Dizziness upon standing
• B. Weight loss
• C. Bradycardia
• D. Hypotension

Correct answer: D

Rationale: The correct answer is D: Hypotension. Carvedilol, a beta-blocker, can lead to hypotension by blocking the effects of adrenaline, which can cause blood vessels to dilate and reduce blood pressure. While dizziness upon standing is a potential adverse effect of carvedilol, it is more specifically related to orthostatic hypotension, which is a form of hypotension that occurs when a person stands up from a sitting or lying position. Weight loss and bradycardia are not typically associated with carvedilol use. Therefore, the nurse should primarily monitor for hypotension in a client taking carvedilol.

4. A client with diabetes mellitus type 2 is prescribed pioglitazone. The nurse should monitor for which potential adverse effect?

• A. Weight gain
• B. Liver toxicity
• C. Kidney stones
• D. Bone fractures

Correct answer: B

Rationale: The correct answer is B, liver toxicity. Pioglitazone is known to cause liver toxicity, so it is essential for the nurse to monitor the client's liver function while on this medication. Monitoring liver function tests can help detect any signs of liver damage early, allowing for timely intervention to prevent serious complications.

5. A client with a history of atrial fibrillation is prescribed amiodarone. The nurse should monitor for which potential side effect?

• A. Pulmonary toxicity
• B. Liver toxicity
• C. Thyroid dysfunction
• D. Bradycardia

Correct answer: A

Rationale: Corrected Rationale: Amiodarone is known to cause pulmonary toxicity, which can manifest as respiratory symptoms. Monitoring for signs such as cough, dyspnea, or chest pain is essential to detect this serious side effect early and prevent further complications. Choices B, C, and D are incorrect because while amiodarone can also cause liver toxicity, thyroid dysfunction, and bradycardia, pulmonary toxicity is the most serious side effect that requires immediate attention due to its potential life-threatening consequences.

Similar Questions