Nursing Elites

1. When caring for a client prescribed Digoxin, which finding should the nurse monitor to assess for potential toxicity?

• A. Bradycardia
• B. Hypertension
• C. Hypoglycemia
• D. Hypercalcemia

Correct answer: A

Rationale: Bradycardia is a common sign of Digoxin toxicity. Digoxin, a cardiac glycoside, can lead to toxic effects such as bradycardia, which is a slow heart rate. Therefore, the nurse should closely monitor the client's heart rate for any significant decreases, as this could indicate Digoxin toxicity and prompt further intervention. Choices B, C, and D are incorrect because Digoxin toxicity typically presents with bradycardia, not hypertension, hypoglycemia, or hypercalcemia.

2. A client has a new prescription for Nitroglycerin sublingual tablets. Which of the following instructions should the nurse include in the discharge teaching?

• A. Take one tablet every 15 minutes until pain is relieved.
• B. Take one tablet every 5 minutes, up to three doses.
• C. Take one tablet at bedtime.
• D. Take one tablet on an empty stomach.

Correct answer: B

Rationale: The correct instruction for Nitroglycerin sublingual tablets is to take one tablet at the onset of chest pain, then repeat every 5 minutes for up to three doses. This regimen helps in relieving angina symptoms effectively. Option A of taking one tablet every 15 minutes is too infrequent and may delay symptom relief. Option C of taking one tablet at bedtime is not appropriate as Nitroglycerin is used for immediate relief of angina. Option D of taking one tablet on an empty stomach is irrelevant since Nitroglycerin is not affected by food intake.

3. When teaching a client with a new prescription for nitroglycerin patches, which of the following instructions should the nurse include?

• A. Apply the patch at the same time every day.
• B. Rotate the application site daily.
• C. Remove the patch for 12 hours each day.
• D. Cut the patch in half if needed.

Correct answer: B

Rationale: The correct instruction for a client with a new prescription for nitroglycerin patches is to rotate the application site daily. This is important to prevent skin irritation and ensure optimal absorption of the medication. Applying the patch at the same time every day (Choice A) is not necessary for nitroglycerin patches. Removing the patch for 12 hours each day (Choice C) would disrupt the continuous delivery of medication. Cutting the patch in half (Choice D) can alter the dose and is not recommended unless directed by a healthcare provider.

4. 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.

5. A healthcare professional is reviewing the medication list of a client who has a new prescription for Metformin to treat type 2 diabetes. Which of the following medications should the healthcare professional identify as placing the client at risk for lactic acidosis?

• A. Metformin
• B. Metoprolol
• C. Lisinopril
• D. Insulin

Correct answer: A

Rationale: Metformin is known to have a risk of causing lactic acidosis, particularly in clients with renal impairment or predisposing conditions. Lactic acidosis is a rare but serious adverse effect of metformin use that can be life-threatening. Metoprolol, Lisinopril, and Insulin do not have a known association with lactic acidosis. Healthcare professionals should monitor clients prescribed metformin carefully, especially those with risk factors, to detect and manage lactic acidosis promptly.

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