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. Which drug classes are NOT typically used to treat angina?

• A. Calcium channel blockers
• B. Organic nitrates
• C. Alpha blockers
• D. Beta blockers

Correct answer: C

Rationale: Angina is primarily treated with calcium channel blockers, organic nitrates, and beta blockers. Alpha blockers are not commonly used in the treatment of angina. Calcium channel blockers help dilate blood vessels, decreasing the workload on the heart. Organic nitrates relax and widen blood vessels, improving blood flow and reducing the heart's workload. Beta blockers reduce the heart rate and blood pressure, decreasing the heart's demand for oxygen. Alpha blockers are more commonly used to treat conditions like hypertension and benign prostatic hyperplasia.

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

• A. Avoid taking aspirin while on this medication.
• B. Take this medication with food.
• C. Avoid eating foods high in potassium.
• D. Take this medication at bedtime.

Correct answer: A

Rationale: The correct answer is to instruct the client to avoid taking aspirin while on Clopidogrel. Clopidogrel is an antiplatelet medication that can increase the risk of bleeding. Aspirin and other NSAIDs can further potentiate this risk, so they should be avoided while taking Clopidogrel to reduce the chance of bleeding complications. Choices B, C, and D are incorrect. There is no specific instruction to take Clopidogrel with food or at bedtime. Avoiding foods high in potassium is not directly related to Clopidogrel use.

4. A client has a new prescription for Amlodipine. Which of the following instructions should the nurse include during discharge teaching?

• A. Take the medication at bedtime.
• B. Avoid drinking grapefruit juice.
• C. Increase your intake of high-sodium foods.
• D. Expect a dry cough.

Correct answer: B

Rationale: The correct instruction for the nurse to include during discharge teaching is to advise the client to avoid drinking grapefruit juice. Grapefruit juice can inhibit the metabolism of amlodipine, a calcium channel blocker, leading to increased drug levels in the blood. This can result in potentiated side effects and potential toxicity. Option A is incorrect as amlodipine is usually taken once daily, not specifically at bedtime. Option C is incorrect because high-sodium foods are generally discouraged in individuals with hypertension. Option D is incorrect as a dry cough is not an expected side effect of amlodipine.

5. A client with cancer and a prescription for methotrexate PO reports bleeding gums while being assessed by a nurse in a provider's clinic. Which of the following actions should the nurse take?

• A. Explain to the client that this is an expected adverse effect.
• B. Check the value of the client's current platelet count.
• C. Instruct the client to use an electric toothbrush.
• D. Have the client make an appointment to see the dentist.

Correct answer: B

Rationale: The correct action for the nurse to take when a client on methotrexate reports bleeding gums is to check the client's current platelet count. Bleeding gums may indicate thrombocytopenia, a decreased platelet count which can be a severe side effect of methotrexate therapy. Monitoring the platelet count is crucial for early detection and management of this potentially life-threatening complication. Choice A is incorrect as bleeding gums in this context may not be an expected adverse effect of methotrexate. Choice C is irrelevant and does not address the potential underlying issue of thrombocytopenia. Choice D is not the primary action needed at this point; checking the platelet count is more urgent to assess the severity of the situation.

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