Nursing Elites

1. 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.

2. A healthcare professional is preparing to administer clindamycin 200 mg by intermittent IV bolus. The amount available is clindamycin injection 200 mg in 100 mL 0.9% sodium chloride (0.9% NaCl) to infuse over 30 min. The healthcare professional should set the IV pump to deliver how many mL/hr?

• A. 200 mL/hr
• B. 150 mL/hr
• C. 100 mL/hr
• D. 250 mL/hr

Correct answer: A

Rationale: To calculate the flow rate in mL/hr: (Volume in mL / Time in hours) = Flow rate in mL/hr. In this case, (100 mL / 0.5 hr) = 200 mL/hr. The correct calculation is: 100 mL (volume) / 0.5 hr (time) = 200 mL/hr. Therefore, the correct answer is 200 mL/hr. Choice B (150 mL/hr), C (100 mL/hr), and D (250 mL/hr) are incorrect as they do not match the calculated flow rate needed for the administration of clindamycin.

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

• A. Increase your intake of high-fiber foods.
• B. Take the medication with grapefruit juice.
• C. Expect to feel drowsy or lightheaded.
• D. Avoid dairy products while taking this medication.

Correct answer: A

Rationale: The correct instruction to include when a client is prescribed Verapamil is to increase their intake of high-fiber foods. Verapamil can cause constipation as a side effect, and increasing fiber intake can help prevent constipation. High-fiber foods promote bowel regularity and can counteract the constipating effects of Verapamil. Choices B, C, and D are incorrect because taking Verapamil with grapefruit juice can lead to adverse reactions, drowsiness or lightheadedness is not a typical side effect of Verapamil, and there is no need to avoid dairy products specifically while taking this medication.

4. A client has a new prescription for Hydralazine. Which of the following side effects should the nurse instruct the client to monitor for and report?

• A. Orthostatic hypotension
• B. Increased heart rate
• C. Dark-colored urine
• D. Persistent cough

Correct answer: B

Rationale: Corrected Rationale: Hydralazine, a vasodilator, can cause reflex tachycardia, leading to an increased heart rate. This side effect should be reported to the healthcare provider to ensure appropriate management and monitoring of the client's condition. Choice A (Orthostatic hypotension) is incorrect as Hydralazine is more likely to cause reflex tachycardia than orthostatic hypotension. Choice C (Dark-colored urine) and Choice D (Persistent cough) are unrelated to the common side effects of Hydralazine and should not be the focus of monitoring for this medication.

5. A client has a new prescription for nitroglycerin sublingual tablets. Which of the following instructions should the nurse include?

• A. Take one tablet at the first sign of chest pain.
• B. If pain is not relieved, take another tablet in 10 minutes.
• C. You can take up to five tablets in 15 minutes.
• D. Swallow the tablet with water.

Correct answer: A

Rationale: The correct instruction for a client with a new prescription for nitroglycerin sublingual tablets is to take one tablet at the first sign of chest pain. If the pain is not relieved after 5 minutes, the client should call 911 and take a second tablet. Taking more than the recommended dose can lead to serious side effects, and swallowing the tablet would not provide the rapid effect needed in cases of chest pain. Choice A is correct because it aligns with the standard protocol for nitroglycerin use in treating angina. Choice B is incorrect as the second tablet should be taken after 5 minutes, not 10 minutes. Choice C is incorrect as taking up to five tablets in 15 minutes is excessive and can result in serious complications. Choice D is incorrect as nitroglycerin sublingual tablets should be placed under the tongue for rapid absorption, not swallowed.

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