Nursing Elites

1. An older adult client has a new prescription for Digoxin and takes multiple other medications. The nurse should recognize that concurrent use of which of the following medications places the client at risk for Digoxin toxicity?

• A. Phenytoin
• B. Verapamil
• C. Warfarin
• D. Aluminum hydroxide

Correct answer: B

Rationale: Verapamil, a calcium-channel blocker, can increase digoxin levels, leading to toxicity. When given together, the digoxin dosage may need adjustment, and the nurse should closely monitor the client's digoxin levels to prevent toxicity symptoms such as nausea, vomiting, visual disturbances, and arrhythmias. The other choices, Phenytoin, Warfarin, and Aluminum hydroxide, do not significantly interact with Digoxin to cause toxicity. Phenytoin may reduce Digoxin levels, while Warfarin and Aluminum hydroxide have minimal interactions with Digoxin.

2. A client has a new prescription for Ramelteon and is receiving teaching from a nurse. The nurse should instruct the client to avoid which of the following foods while taking this medication?

• A. Baked potato
• B. Fried chicken
• C. Whole-grain bread
• D. Citrus fruits

Correct answer: B

Rationale: The correct answer is B: Fried chicken. High-fat foods like fried chicken can prolong the absorption of Ramelteon, potentially reducing its effectiveness. It is important to avoid such foods to ensure the medication works as intended.

3. A client is taking metformin for type 2 diabetes. Which of the following findings should indicate to the nurse that the medication is effective?

• A. Increased urine output
• B. Decreased fasting blood glucose
• C. Decreased hemoglobin A1C
• D. Decreased polyuria

Correct answer: C

Rationale: A decrease in hemoglobin A1C is a more specific indicator of metformin's effectiveness in controlling blood glucose levels over a longer period compared to fasting blood glucose levels. Hemoglobin A1C reflects average blood sugar levels over the past 2-3 months, providing a more comprehensive view of glycemic control. Increased urine output (choice A) is not a direct indicator of metformin's effectiveness and can be influenced by various factors. Decreased fasting blood glucose (choice B) can fluctuate due to various reasons and may not provide a reliable long-term assessment of metformin's efficacy. Decreased polyuria (choice D) refers to a symptom rather than a direct measure of metformin's effectiveness in managing diabetes.

4. Which medication is used as a bronchodilator?

• A. Warfarin
• B. Lovastatin
• C. Albuterol
• D. Valproate

Correct answer: C

Rationale: Albuterol is the correct answer. It is a medication commonly used as a bronchodilator to treat conditions such as asthma. Albuterol works by relaxing the muscles in the airways, allowing better airflow and making breathing easier for individuals with respiratory conditions. Warfarin (Choice A) is an anticoagulant used to prevent blood clots, Lovastatin (Choice B) is a medication used to lower cholesterol levels, and Valproate (Choice D) is used to treat seizures and bipolar disorder. These medications are not bronchodilators and are used for different medical conditions.

5. Which of the following is commonly used to treat migraine headaches?

• A. Beta-blockers
• B. Cholinesterase Inhibitors
• C. ACE inhibitors
• D. Anti-epileptic drugs (AEDs)

Correct answer: D

Rationale: Anti-epileptic drugs (AEDs) are often used in the management of migraine headaches due to their ability to help prevent or reduce the frequency and intensity of migraines. They work by stabilizing electrical activity in the brain, which can help in controlling migraine symptoms. While beta-blockers are also sometimes used in migraine prevention, anti-epileptic drugs are more commonly associated with migraine treatment. Cholinesterase Inhibitors are not typically used for migraine headaches, as they are more commonly associated with conditions like Alzheimer's disease. ACE inhibitors are a type of medication used to treat conditions like high blood pressure and heart failure, but they are not a first-line treatment for migraines.

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