Nursing Elites

1. A client has a new prescription for Digoxin. Which of the following instructions should the nurse provide?

• A. Monitor your heart rate before taking the medication.
• B. Increase your intake of high-potassium foods.
• C. Take the medication with a full glass of milk.
• D. Expect your stools to be black and tarry.

Correct answer: A

Rationale: Clients prescribed Digoxin should monitor their heart rate before each dose. This is essential to identify any potential bradycardia, defined as a heart rate below 60 bpm, which can be a side effect of Digoxin. Any significant changes in heart rate should be reported promptly to the healthcare provider for further evaluation and management. Choice B is incorrect because increasing intake of high-potassium foods can lead to hyperkalemia, a condition that can be exacerbated by Digoxin. Choice C is incorrect as taking Digoxin with a full glass of milk is not necessary. Choice D is incorrect as black, tarry stools are not an expected side effect of Digoxin.

2. A client has a new prescription for Labetalol. Which of the following instructions should be provided?

• A. Take the medication with food.
• B. Monitor your blood glucose levels.
• C. Expect a rapid heart rate.
• D. Increase your intake of high-sodium foods.

Correct answer: A

Rationale: The correct answer is A: Take the medication with food. Labetalol should be taken with food to increase absorption and reduce the risk of orthostatic hypotension. Taking it with food helps in better absorption and minimizes the potential drop in blood pressure when standing up, which can occur with this medication. Choice B is incorrect as Labetalol is not primarily associated with affecting blood glucose levels. Choice C is incorrect as Labetalol is a beta-blocker that would actually lower heart rate, not increase it. Choice D is incorrect because increasing intake of high-sodium foods could counteract the antihypertensive effects of Labetalol.

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

• A. Expect a rapid heart rate.
• B. Take the medication with meals.
• C. Report any signs of restlessness or involuntary movements.
• D. Avoid consuming dairy products.

Correct answer: C

Rationale: The correct instruction to include when teaching a client about Metoclopramide is to report any signs of restlessness or involuntary movements. Metoclopramide can lead to extrapyramidal symptoms, such as restlessness or involuntary movements. It is essential for clients to notify their healthcare provider if they experience these symptoms to receive appropriate management.

4. A healthcare professional is preparing to administer morphine 4 mg IV to a client. Available is morphine 10 mg/mL. How many mL should the healthcare professional administer?

• A. 0.2 mL
• B. 0.4 mL
• C. 0.6 mL
• D. 0.8 mL

Correct answer: B

Rationale: To administer 4 mg from a solution of 10 mg/mL, the healthcare professional should administer 0.4 mL. The calculation is done by dividing the desired dose (4 mg) by the concentration of the solution (10 mg/mL), which equals 0.4 mL. Choice A (0.2 mL) is incorrect because it is half of the correct calculation. Choice C (0.6 mL) is incorrect because it is 50% more than the correct calculation. Choice D (0.8 mL) is incorrect because it exceeds the correct calculation.

5. A client with streptococcal pneumonia is receiving penicillin G by intermittent IV bolus. 10 minutes into the infusion of the third dose, the client reports itching at the IV site, dizziness, and shortness of breath. What should the nurse do first?

• A. Stop the infusion.
• B. Call the provider.
• C. Elevate the head of the bed.
• D. Auscultate breath sounds.

Correct answer: A

Rationale: In this scenario, the client is exhibiting signs of anaphylaxis, a severe allergic reaction. The priority action for the nurse is to stop the infusion immediately to prevent further administration of the allergen and worsening symptoms. Once the infusion is stopped, the nurse can then proceed with additional interventions, such as calling the provider, assessing the client's respiratory status, and providing appropriate care as needed.

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