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 assisting in caring for a client in the telemetry unit who is receiving an intravenous infusion of 1000 mL of 5% dextrose with 40 mEq of potassium chloride. Which occurrence observed on the cardiac monitor indicates the presence of hyperkalemia?

• A. Tall, peaked T waves
• B. ST segment depressions
• C. Shortened P-R intervals
• D. Shortening of the QRS complex

Correct answer: A

Rationale: In hyperkalemia, tall, peaked T waves are a distinct ECG finding. These T waves can be seen as a result of increased serum potassium levels, affecting the repolarization phase of the cardiac action potential. It is crucial for healthcare providers to recognize this ECG change promptly as hyperkalemia can lead to serious cardiac arrhythmias and complications. ST segment depressions, shortened P-R intervals, and shortening of the QRS complex are not typically associated with hyperkalemia. ST segment depressions are more indicative of myocardial ischemia or infarction. Shortened P-R intervals may be seen in conditions like Wolff-Parkinson-White syndrome. Shortening of the QRS complex is associated with conditions affecting the conduction system of the heart, such as bundle branch blocks.

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

• A. Monitor blood pressure daily.
• B. Take the medication with food.
• C. Increase intake of potassium-rich foods.
• D. Avoid consuming grapefruit juice.

Correct answer: A

Rationale: The correct answer is to instruct the client to monitor their blood pressure daily. Lisinopril is known to cause hypotension, so monitoring blood pressure regularly is essential to detect any potential issues early on. Choice B is incorrect as lisinopril is usually taken on an empty stomach. Choice C is incorrect as lisinopril can increase potassium levels, so additional intake of potassium-rich foods may lead to hyperkalemia. Choice D is incorrect because grapefruit juice can interact with lisinopril, leading to adverse effects.

4. The nurse is planning measures to decrease the incidence of chest pain for a client with angina pectoris. What intervention should the nurse do to effectively accomplish this goal?

• A. Provide a quiet and low-stimulus environment.
• B. Encourage the family to visit very frequently.
• C. Encourage the client to call friends and relatives each day.
• D. Recommend that the client watch TV as a constant diversion.

Correct answer: A

Rationale: The correct answer is A: Provide a quiet and low-stimulus environment. A calm and quiet environment can help reduce stress, which is beneficial in preventing the occurrence of chest pain in clients with angina. Choice B is incorrect because excessive or frequent visitations may lead to increased stress and agitation for the client. Choice C is incorrect as it may not always contribute to a calm environment and could potentially increase the client's stress levels. Choice D is inappropriate as watching TV constantly may not promote a quiet and low-stimulus environment, which is essential in managing angina pectoris.

5. The healthcare professional is assessing a client who presents with jaundice. Which assessment finding is most important for the healthcare professional to follow up on?

• A. Urine specific gravity of 1.03
• B. Frothy, tea-colored urine
• C. Clay-colored stools
• D. Elevated serum amylase and lipase levels

Correct answer: D

Rationale: Elevated serum amylase and lipase levels are indicative of pancreatitis, a serious condition that can manifest with jaundice. Timely follow-up is crucial to manage pancreatitis and its complications effectively in a jaundiced client. Choices A, B, and C are less critical in this scenario. Urine specific gravity within normal range, frothy tea-colored urine, and clay-colored stools can be associated with various conditions but are not directly indicative of pancreatitis, which is the most concerning condition associated with jaundice.

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