Nursing Elites

1. A client with chronic heart failure is being discharged with a prescription for digoxin (Lanoxin). Which instruction should the nurse reinforce?

• A. Take the medication at the same time each day.
• B. Avoid foods high in potassium.
• C. Skip a dose if you feel well.
• D. Take the medication on an empty stomach.

Correct answer: A

Rationale: Taking digoxin at the same time each day is essential to maintain a consistent blood level of the medication. This consistency helps optimize the therapeutic effects of digoxin in managing chronic heart failure. Deviating from the scheduled time could lead to fluctuations in drug levels, affecting its effectiveness and potentially causing harm. Choices B, C, and D are incorrect because avoiding potassium-rich foods, skipping doses when feeling well, and taking the medication on an empty stomach are not relevant or appropriate instructions for a client prescribed digoxin.

2. A healthcare professional is reviewing laboratory results for a client with rheumatoid arthritis prescribed methotrexate. Which of the following laboratory results should the healthcare professional report to the provider?

• A. WBC count 1,200/mm³
• B. Hemoglobin 14 g/dL
• C. Platelets 150,000/mm³
• D. Blood glucose 110 mg/dL

Correct answer: A

Rationale: A WBC count of 1,200/mm³ indicates leukopenia, a serious side effect of methotrexate that can lead to increased risk of infections. It is crucial to report this finding promptly to the provider for further evaluation and possible adjustments in the treatment plan. Choices B, C, and D are within normal ranges and do not represent significant concerns related to methotrexate therapy in this context.

3. A client has a new prescription for enalapril. Which of the following instructions should the nurse include?

• A. Monitor for a dry cough.
• B. Take the medication at bedtime.
• C. Avoid consuming grapefruit juice.
• D. Take the medication with food.

Correct answer: A

Rationale: The correct answer is A: Monitor for a dry cough. When a client is prescribed enalapril, it is important to monitor for a dry cough because it can be a side effect that indicates a potential issue like angioedema. This side effect needs close attention as it may require discontinuation of the medication to prevent further complications. Choices B, C, and D are incorrect because enalapril does not need to be taken at bedtime, does not interact with grapefruit juice, and can be taken without regard to meals.

4. A client with hypertension is prescribed a thiazide diuretic. What instruction should the nurse reinforce to the client?

• A. Take the medication in the morning.
• B. Increase potassium intake in the diet.
• C. Weigh yourself daily.
• D. Limit fluid intake to 2 liters per day.

Correct answer: C

Rationale: The correct answer is to weigh oneself daily. This instruction is important as daily weights help monitor fluid loss and are crucial for detecting early signs of fluid imbalance when taking a diuretic. Weighing daily allows for timely adjustments in treatment and helps prevent complications associated with fluid imbalance. Choice A is not directly related to the client's need for monitoring fluid balance. Choice B, although important for some diuretics, is not specific to thiazide diuretics. Choice D is not appropriate as limiting fluid intake without proper monitoring can lead to dehydration, especially when taking diuretics.

5. After returning the client to bed following a cardiac catheterization procedure with the left femoral vessel as the access site, the nurse places a sign above the bed instructing the client to remain on bed rest and in which position?

• A. In semi-Fowler's position
• B. With the head of the bed elevated 45 degrees
• C. With the head of the bed elevated no more than 15 degrees
• D. With the foot of the bed elevated as much as tolerated by the client

Correct answer: C

Rationale: After cardiac catheterization via the femoral vessel, it is crucial to keep the head of the bed elevated no more than 15 degrees to prevent bleeding at the access site. This position helps maintain pressure on the femoral artery, reducing the risk of bleeding and complications post-procedure. Choices A, B, and D are incorrect because they do not provide the necessary pressure on the femoral artery to prevent bleeding, which is essential after a cardiac catheterization procedure with a femoral access site.

Similar Questions