Nursing Elites

1. A client has a new prescription for Digoxin for heart failure. Which of the following adverse effects should the client monitor for and report to the provider?

• A. Dry cough
• B. Pedal edema
• C. Bruising
• D. Yellow-tinged vision

Correct answer: D

Rationale: The correct answer is D: Yellow-tinged vision. Yellow-tinged vision is a potential adverse effect of Digoxin and may indicate toxicity. Clients should be instructed to report this symptom promptly to the healthcare provider to prevent complications. Dry cough (choice A) is not typically associated with Digoxin. Pedal edema (choice B) is more commonly seen with heart failure but is not a direct adverse effect of Digoxin. Bruising (choice C) is not a common adverse effect of Digoxin.

2. A client has a new prescription for Albuterol and Beclomethasone inhalers for the control of asthma. Which of the following instructions should the nurse include in the teaching?

• A. Take the albuterol at the same time each day.
• B. Administer the albuterol inhaler before using the beclomethasone inhaler.
• C. Use beclomethasone if experiencing an acute episode.
• D. Avoid shaking the beclomethasone before use.

Correct answer: B

Rationale: When a client is prescribed an inhaled beta2-agonist (such as albuterol) and an inhaled glucocorticoid (such as beclomethasone) for asthma control, the beta2-agonist should be administered first. Administering the beta2-agonist before the glucocorticoid helps promote bronchodilation and enhances the absorption of the glucocorticoid, maximizing its effectiveness in the lungs. Choice A is incorrect because albuterol is usually taken as needed for quick relief of asthma symptoms and not necessarily at the same time each day. Choice C is incorrect as beclomethasone is a controller medication used for long-term asthma management, not for acute episodes. Choice D is incorrect as shaking the beclomethasone inhaler before use helps ensure proper medication dispersion for effective inhalation.

3. A client is prescribed Lithium. Which of the following laboratory values should be monitored to assess for potential toxicity?

• A. Serum sodium
• B. Serum lithium
• C. Serum potassium
• D. Serum calcium

Correct answer: B

Rationale: When a client is prescribed Lithium, monitoring serum lithium levels is crucial to ensure they remain within the therapeutic range and to assess for potential toxicity. Monitoring serum lithium levels helps prevent adverse effects associated with lithium toxicity, such as nausea, vomiting, diarrhea, tremors, and confusion.

4. A client has a new prescription for methotrexate to treat Rheumatoid Arthritis. The nurse should expect to monitor the client for which of the following adverse effects?

• A. Insomnia
• B. Hypertension
• C. Bone marrow suppression
• D. Constipation

Correct answer: C

Rationale: The correct answer is bone marrow suppression. Methotrexate can lead to bone marrow suppression, resulting in anemia, leukopenia, and thrombocytopenia. Monitoring for signs of decreased blood cell counts is crucial to prevent complications. Insomnia (choice A), hypertension (choice B), and constipation (choice D) are not typically associated with methotrexate use for Rheumatoid Arthritis.

5. A client with increased liver enzymes is taking herbal supplements. Which of the following herbal supplements should the nurse report to the provider?

• A. Glucosamine
• B. Saw palmetto
• C. Kava
• D. St. John's wort

Correct answer: C

Rationale: The nurse should report kava to the provider because chronic use or high doses of kava can lead to liver damage, including severe liver failure. It is crucial for the nurse to be vigilant about any herbal supplement that could potentially worsen the client's liver condition.

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