Nursing Elites

1. A healthcare professional in a provider's office is monitoring serum electrolytes for four older adult clients who take digoxin. Which of the following electrolyte values increases a client's risk for Digoxin toxicity?

• A. Calcium 9.2 mg/dL
• B. Calcium 10.3 mg/dL
• C. Potassium 3.4 mEq/L
• D. Potassium 4.8 mEq/L

Correct answer: C

Rationale: The correct answer is C: Potassium 3.4 mEq/L. Potassium 3.4 mEq/L is below the expected reference range and puts a client at risk for digoxin toxicity. Low potassium levels can lead to fatal dysrhythmias, especially in older clients taking Digoxin, as potassium plays a crucial role in the heart's electrical activity. Choices A and B are related to calcium levels, which do not directly increase the risk of Digoxin toxicity. Choice D, Potassium 4.8 mEq/L, is within the expected reference range and would not increase the risk of Digoxin toxicity.

2. A client has a new prescription for Verapamil to treat angina. The nurse should instruct the client to monitor for which of the following adverse effects?

• A. Muscle pain
• B. Dry cough
• C. Peripheral edema
• D. Increased urination

Correct answer: C

Rationale: Verapamil, a calcium channel blocker, can cause peripheral edema due to vasodilation. Clients should monitor for this adverse effect characterized by swelling in the extremities. Muscle pain (choice A) is not a common adverse effect of Verapamil. Dry cough (choice B) is more commonly associated with ACE inhibitors. Increased urination (choice D) is not a typical adverse effect of Verapamil. Therefore, the correct answer is monitoring for peripheral edema.

3. A client is receiving discharge instructions for a new prescription of Warfarin. Which of the following over-the-counter medications should the client be instructed to avoid?

• A. Acetaminophen
• B. Ibuprofen
• C. Diphenhydramine
• D. Loratadine

Correct answer: B

Rationale: The correct answer is B: Ibuprofen. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can increase the risk of bleeding when taken with Warfarin due to its antiplatelet effects. Patients on Warfarin should avoid NSAIDs like Ibuprofen and opt for alternative pain relief options to prevent potential complications such as an increased risk of bleeding. Acetaminophen (Choice A), Diphenhydramine (Choice C), and Loratadine (Choice D) are not known to significantly interact with Warfarin in terms of bleeding risk and are generally considered safe to use alongside Warfarin.

4. What is the expected outcome of Valproate therapy?

• A. Decreased fever
• B. Decreased sense of anxiety
• C. Decreased blood pressure
• D. Decreased seizure activity

Correct answer: D

Rationale: The correct answer is D: Decreased seizure activity. Valproate is commonly used in the treatment of epilepsy to help control and reduce seizure frequency. Choices A, B, and C are incorrect because Valproate is not primarily used to treat fever, anxiety, or blood pressure issues.

5. A client is prescribed Clopidogrel. Which of the following laboratory values should be monitored to assess for potential adverse effects?

• A. White blood cell count
• B. Platelet count
• C. Hemoglobin
• D. Blood glucose

Correct answer: B

Rationale: Clopidogrel is an antiplatelet medication, so monitoring the client's platelet count is crucial to assess for potential bleeding complications. Changes in platelet count can indicate an increased risk of bleeding, a known adverse effect of Clopidogrel. Monitoring white blood cell count, hemoglobin, or blood glucose is not directly related to the potential adverse effects of Clopidogrel and would not provide relevant information regarding the medication's impact on platelet function.

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