Nursing Elites

1. A client has a prescription for digoxin. The client should be monitored for which of the following findings as an indication of digoxin toxicity?

• A. Visual disturbances
• B. Tachycardia
• C. Increased appetite
• D. Constipation

Correct answer: A

Rationale: Visual disturbances, such as yellow-tinged vision or seeing halos around lights, are common signs of digoxin toxicity. These symptoms should be reported immediately to healthcare providers for further evaluation and management. Tachycardia (Choice B) is not typically associated with digoxin toxicity. Increased appetite (Choice C) and constipation (Choice D) are not common manifestations of digoxin toxicity. Therefore, the correct answer is visual disturbances.

2. A client prescribed Warfarin is receiving discharge instructions from a nurse. Which of the following dietary instructions should the nurse include?

• A. Increase your intake of leafy green vegetables.
• B. Avoid foods high in vitamin K.
• C. Increase your intake of dairy products.
• D. Avoid foods high in iron.

Correct answer: B

Rationale: The correct answer is B: 'Avoid foods high in vitamin K.' Vitamin K can interfere with the effectiveness of Warfarin, an anticoagulant medication. Foods high in vitamin K, such as leafy green vegetables, can reduce the medication's anticoagulant effect. Therefore, clients taking Warfarin should be advised to avoid or consume a consistent amount of foods high in vitamin K to maintain the medication's effectiveness. Choices A, C, and D are incorrect because increasing leafy green vegetables, dairy products, or avoiding foods high in iron are not directly related to the interaction with Warfarin.

3. When administering Lithium to a patient, what is a life-threatening side effect?

• A. Erythema
• B. Pancreatitis
• C. Seizures
• D. Headache

Correct answer: C

Rationale: When a patient is being treated with Lithium, a life-threatening side effect to watch out for is seizures. Lithium can lower the seizure threshold, increasing the risk of seizures. Seizures are serious and necessitate prompt medical intervention to ensure the patient's safety and well-being. Erythema, which is redness of the skin, is not a common life-threatening side effect of Lithium. Pancreatitis can be a side effect of Lithium, but it is not typically life-threatening. Headache is a common side effect of Lithium, but it is not considered life-threatening.

4. A client is taking Warfarin for atrial fibrillation. Which of the following client statements indicates a need for further teaching?

• A. I will avoid eating broccoli.
• B. I will use an electric razor to shave.
• C. I will take aspirin for headaches.
• D. I will have my blood tested regularly.

Correct answer: C

Rationale: The correct answer is C. Taking aspirin along with Warfarin can increase the risk of bleeding. Clients should be advised to avoid medications that increase the risk of bleeding when taking Warfarin to prevent complications. Choices A, B, and D are all correct statements indicating good understanding of Warfarin therapy. Avoiding foods high in Vitamin K, using an electric razor to prevent cuts that can lead to bleeding, and regular blood testing to monitor Warfarin levels are all important aspects of managing Warfarin therapy.

5. A healthcare provider is caring for several clients who came to the clinic for a seasonal influenza immunization. The provider should identify that which of the following clients is a candidate to receive the vaccine via nasal spray rather than an injection?

• A. 1-year-old who has no health problems
• B. 17-year-old who has a hypersensitivity to Penicillin
• C. 25-year-old who is pregnant
• D. 52-year-old who takes a multivitamin supplement

Correct answer: B

Rationale: The correct answer is B. A 17-year-old can receive the influenza vaccine via nasal spray even if they have a hypersensitivity to penicillin, as this is not a contraindication for the influenza immunization. The nasal spray vaccine (LAIV) is a live attenuated vaccine that is suitable for healthy individuals aged 2-49 years. Pregnancy (choice C) is a contraindication for the nasal spray influenza vaccine. Children under 2 years of age (choice A) are also not candidates for the nasal spray. Taking a multivitamin supplement (choice D) is not a determining factor for the type of influenza vaccine a person should receive.

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