Nursing Elites

1. A healthcare professional is assessing a client who is taking digoxin. Which of the following findings should the healthcare professional report to the provider?

• A. Weight gain
• B. Dry cough
• C. Hypokalemia
• D. Bradycardia

Correct answer: D

Rationale: Bradycardia is a significant finding in a client taking digoxin as it is a sign of digoxin toxicity. Bradycardia can indicate that the client is experiencing an adverse reaction to the medication, potentially leading to serious complications. Therefore, it is crucial for the healthcare professional to report bradycardia to the provider promptly for further evaluation and intervention. Weight gain, dry cough, and hypokalemia are not typically associated with digoxin toxicity and may have other underlying causes. While weight gain and cough can be monitored, bradycardia requires immediate attention due to its potential link to digoxin toxicity.

2. The LPN/LVN is reinforcing instructions to a client on the use of a metered-dose inhaler. The nurse should recognize that the client is using the inhaler correctly if the client takes which action?

• A. Takes a deep breath and then exhales just before administration
• B. Holds the mouthpiece 1 to 2 inches from the mouth
• C. Inhales the medication and then exhales immediately after administration
• D. Performs 3 short inhalations and then exhales deeply after administration

Correct answer: A

Rationale: When using a metered-dose inhaler, the client should take a deep breath and then exhale just before administration. This technique helps ensure that the medication is inhaled effectively. By exhaling before administration, the client can fully inhale the medication into the lungs, maximizing its therapeutic effects. Choice B is incorrect because holding the mouthpiece 1 to 2 inches from the mouth is not a crucial step for using a metered-dose inhaler correctly. Choice C is incorrect because inhaling the medication and then exhaling immediately after administration would not allow the medication to be adequately absorbed into the lungs. Choice D is incorrect because performing 3 short inhalations and then exhaling deeply after administration is not the correct technique for using a metered-dose inhaler.

3. A client diagnosed with thrombophlebitis 1 day ago suddenly complains of chest pain and shortness of breath. The LPN/LVN understands that a life-threatening complication of this condition is which?

• A. Pneumonia
• B. Pulmonary edema
• C. Pulmonary embolism
• D. Myocardial infarction

Correct answer: C

Rationale: The correct answer is C, Pulmonary embolism. Pulmonary embolism is a critical complication of thrombophlebitis where a blood clot dislodges and travels to the lungs, obstructing blood flow. This obstruction can lead to chest pain, shortness of breath, and potentially fatal consequences, making it a life-threatening emergency that requires prompt intervention. Choices A, B, and D are incorrect because pneumonia, pulmonary edema, and myocardial infarction are not directly associated with thrombophlebitis and would not present with the sudden onset of chest pain and shortness of breath in this context.

4. A client with a history of atrial fibrillation is prescribed warfarin (Coumadin). Which laboratory value should the nurse monitor to assess the effectiveness of the medication?

• A. Activated partial thromboplastin time (aPTT)
• B. Prothrombin time (PT) and international normalized ratio (INR)
• C. Platelet count
• D. Erythrocyte sedimentation rate (ESR)

Correct answer: B

Rationale: Prothrombin time (PT) and international normalized ratio (INR) are the laboratory values used to monitor the effectiveness of warfarin therapy. These values help ensure that the client is within the therapeutic range for anticoagulation. PT measures the time it takes for blood to clot, while INR standardizes PT results to minimize variations between laboratories. Monitoring these values is crucial to prevent complications such as bleeding or clot formation. Activated partial thromboplastin time (aPTT) (Choice A) is more commonly used to monitor heparin therapy. Platelet count (Choice C) assesses the number of platelets in the blood and is not specific to warfarin therapy. Erythrocyte sedimentation rate (ESR) (Choice D) is a non-specific marker of inflammation and is not used to monitor the effectiveness of warfarin therapy.

5. The client is being taught about the use of sublingual nitroglycerin for chest pain. Which instruction should be provided?

• A. Swallow the tablet whole with water.
• B. Place the tablet under the tongue and let it dissolve.
• C. Chew the tablet and then swallow.
• D. Place the tablet between the cheek and gum.

Correct answer: B

Rationale: The correct method for administering sublingual nitroglycerin is to place the tablet under the tongue and allow it to dissolve. This route of administration facilitates rapid absorption of the medication into the bloodstream, enabling quick relief of chest pain associated with angina or heart conditions. Choice A is incorrect because sublingual nitroglycerin should not be swallowed whole. Choice C is wrong as chewing the tablet can lead to the rapid release of the drug, causing adverse effects like headaches or dizziness. Choice D is also incorrect as the tablet should not be placed between the cheek and gum, but under the tongue for proper absorption.

Similar Questions