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 in an acute care facility is receiving IV Nitroprusside for hypertensive crisis. The nurse should monitor the client for which of the following adverse reactions to this medication?

• A. Intestinal ileus
• B. Neutropenia
• C. Delirium
• D. Hyperthermia

Correct answer: C

Rationale: The correct answer is C: Delirium. When IV nitroprusside is administered at high dosages, it can lead to thiocyanate toxicity, resulting in mental status changes such as delirium. Monitoring thiocyanate levels during therapy is crucial to ensure they remain below 10 mg/dL to prevent this adverse reaction. Choices A, B, and D are incorrect because nitroprusside does not typically cause intestinal ileus, neutropenia, or hyperthermia as adverse reactions.

3. Which of the following drugs has a therapeutic effect that increases cardiac output and slows heart rate?

• A. Heparin
• B. Alprazolam
• C. Digoxin
• D. Levothyroxine

Correct answer: C

Rationale: Digoxin is the correct answer. It is a medication known for its positive inotropic effects, which increase cardiac output, and negative chronotropic effects, which slow the heart rate. These effects are achieved by inhibiting the sodium-potassium ATPase pump in myocardial cells. Therefore, Digoxin is commonly prescribed to manage conditions like heart failure and atrial fibrillation, where enhancing cardiac output and reducing heart rate are beneficial. Choices A, B, and D are incorrect because Heparin is an anticoagulant, Alprazolam is a benzodiazepine used for anxiety disorders, and Levothyroxine is a thyroid hormone replacement drug, none of which have the specified therapeutic effects on cardiac function.

4. A client is receiving discharge teaching for Metronidazole prescribed for an infection. Which statement by the client indicates an understanding of the teaching?

• A. I should avoid drinking alcohol while taking this medication.
• B. I should take this medication with food.
• C. I should increase my intake of dairy products while taking this medication.
• D. I should avoid taking dairy products while taking this medication.

Correct answer: A

Rationale: The correct answer is A. Alcohol should be avoided while taking Metronidazole because it can lead to a disulfiram-like reaction, causing severe nausea and vomiting. It is important for the client to understand this to prevent adverse reactions and ensure the effectiveness of the medication in treating the infection. Choices B, C, and D are incorrect because taking Metronidazole with food is recommended to decrease gastrointestinal upset, and there is no specific need to increase or avoid dairy products while taking this medication.

5. When caring for a client prescribed Digoxin, which of the following laboratory values should the nurse monitor to assess for potential toxicity?

• A. Sodium
• B. Potassium
• C. Magnesium
• D. Calcium

Correct answer: B

Rationale: When a client is prescribed Digoxin, monitoring potassium levels is crucial as hypokalemia can increase the risk of Digoxin toxicity. Low potassium levels can potentiate the effects of Digoxin on the heart, leading to toxicity. Therefore, regular monitoring of potassium levels helps in preventing adverse effects and ensuring the safe use of Digoxin. Sodium, magnesium, and calcium levels are not directly associated with Digoxin toxicity; hence, they are not the primary focus for monitoring in this case.

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