Nursing Elites

1. A client with a history of atrial fibrillation is prescribed digoxin. The nurse should monitor for which sign of digoxin toxicity?

• A. Bradycardia
• B. Tachycardia
• C. Nausea
• D. Vomiting

Correct answer: A

Rationale: Bradycardia is a common sign of digoxin toxicity. Digoxin, a medication used to treat atrial fibrillation, can lead to toxicity manifesting as various cardiac dysrhythmias, with bradycardia being a notable indicator. Monitoring for bradycardia is crucial as it can indicate the need for dosage adjustment or discontinuation of digoxin to prevent adverse effects. Tachycardia, nausea, and vomiting are not typically associated with digoxin toxicity, making them incorrect choices for monitoring in a client receiving this medication.

2. A client with hypertension is prescribed amlodipine. The nurse should monitor for which potential adverse effect?

• A. Peripheral edema
• B. Bradycardia
• C. Hypertension
• D. Increased appetite

Correct answer: A

Rationale: Corrected Rationale: Amlodipine is known to cause peripheral edema as a potential adverse effect due to its vasodilatory properties. This can lead to fluid accumulation in the extremities. Monitoring for peripheral edema in patients taking amlodipine is crucial to identify and manage this side effect promptly. Choices B, C, and D are incorrect because amlodipine is not associated with causing bradycardia, hypertension (as the patient already has hypertension), or increased appetite as adverse effects.

3. A client with chronic kidney disease is prescribed ferric citrate. The nurse should monitor for which potential side effect?

• A. Constipation
• B. Diarrhea
• C. Nausea
• D. Hyperphosphatemia

Correct answer: A

Rationale: When a client with chronic kidney disease is prescribed ferric citrate, the nurse should monitor for constipation as a potential side effect. Ferric citrate can lead to constipation due to its effects on the gastrointestinal system, causing a decrease in bowel movements. It is essential for the nurse to assess and manage constipation promptly to prevent complications and ensure the client's comfort and well-being. Monitoring bowel movements, providing adequate hydration, and recommending dietary interventions can help alleviate constipation in clients taking ferric citrate. Diarrhea, nausea, and hyperphosphatemia are not typically associated with the use of ferric citrate in clients with chronic kidney disease.

4. A client who takes metformin for diabetes mellitus type 2 is nothing by mouth (NPO) for surgery. What pre-op prescription should the practical nurse (PN) anticipate for this client's glucose management?

• A. NPO except for metformin and regular snacks
• B. NPO except for oral antidiabetic agent
• C. Novolin-N insulin subcutaneously twice daily
• D. Regular insulin subcutaneously per sliding scale

Correct answer: D

Rationale: When a client taking metformin for diabetes mellitus type 2 is NPO for surgery, it is crucial to manage their glucose levels effectively. The best approach in this situation is to prescribe regular insulin subcutaneously according to a sliding scale based on the client's blood glucose levels. This method allows for precise adjustment of insulin doses to maintain blood glucose within the target range while the client is unable to take oral medications. Choices A and B are incorrect because metformin is typically held when a client is NPO, and oral antidiabetic agents may not provide sufficient glucose control. Choice C is incorrect as Novolin-N insulin given twice daily may not offer the flexibility needed for glucose management in a surgical setting where the client's intake is restricted.

5. The nurse is caring for a patient with short-term persistent diarrhea. Which class of medication would the nurse anticipate giving?

• A. Lubricants
• B. Probiotics
• C. Adsorbents
• D. Anticholinergics

Correct answer: B

Rationale: Probiotics are the correct choice in this scenario as they help restore normal gut flora, which can be effective in treating diarrhea by promoting a healthy balance of bacteria in the intestines. Lubricants are used to ease bowel movements and are not indicated for treating diarrhea. Adsorbents work by binding to toxins in the gut, which is not the primary mechanism needed for treating diarrhea. Anticholinergics are more commonly used for conditions like overactive bladder and not for short-term persistent diarrhea.

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