Nursing Elites

1. A nurse is providing discharge teaching to a client who has heart failure and a new prescription for digoxin 0.215 mg PO daily and furosemide 20 mg PO daily. Which of the following statements by the client indicates an understanding of the teaching?

• A. I know that blurred vision is something I will expect to happen while taking digoxin.
• B. I will measure my urine output each day and document it in my diary.
• C. I will skip a dose of my digoxin if my resting heart rate is below 72 beats per minute.
• D. I will eat fruits and vegetables that have high potassium content every day.

Correct answer: D

Rationale: Clients taking digoxin and furosemide are at risk for hypokalemia. Eating potassium-rich foods can help maintain normal potassium levels.

2. A nurse is caring for a client who has a new prescription for amphotericin B. The nurse should plan to monitor the client for which of the following adverse effects?

• A. Hyperkalemia
• B. Hypertension
• C. Constipation
• D. Nephrotoxicity

Correct answer: D

Rationale: Correct. Amphotericin B is known for its nephrotoxicity, which can lead to kidney damage. Monitoring kidney function is crucial to detect any signs of nephrotoxicity early. Choices A, B, and C are incorrect because hyperkalemia, hypertension, and constipation are not typically associated with amphotericin B use. Therefore, the nurse should focus on monitoring for nephrotoxicity.

3. A nurse is reviewing laboratory values for a client who reports fatigue and cold intolerance. The client has an increased thyroid stimulating hormone (TSH) level and a decreased total T3 and T4 level. The nurse should anticipate a prescription for which of the following medications?

• A. Methimazole
• B. Somatropin
• C. Levothyroxine
• D. Propylthiouracil

Correct answer: C

Rationale: Levothyroxine is the correct answer. In this scenario, the client's elevated TSH and decreased T3 and T4 levels indicate hypothyroidism, a condition where the thyroid gland does not produce enough hormones. Levothyroxine is a synthetic form of thyroid hormone that is used to replace or supplement the body's naturally produced thyroid hormones. Methimazole and Propylthiouracil are used to treat hyperthyroidism by reducing the production of thyroid hormones. Somatropin is a growth hormone used to treat growth hormone deficiency and other conditions unrelated to thyroid disorders.

4. A nurse is preparing to administer lactated Ringer's (LR) 1,000 mL IV to infuse over 8 hr. The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number).

• A. 21 gtt/min
• B. 20 gtt/min
• C. 25 gtt/min
• D. 18 gtt/min

Correct answer: A

Rationale: To calculate the IV infusion rate in gtt/min: 1000 mL / 480 min × 10 gtt/mL = 20.83 ≈ 21 gtt/min. Therefore, the correct answer is A. Choice B (20 gtt/min) is incorrect because the calculation results in 20.83 gtt/min, rounded to 21. Choices C (25 gtt/min) and D (18 gtt/min) are incorrect as they are not the closest whole number approximation to the calculated value.

5. A nurse is caring for an older adult client who has a prescription for zolpidem at bedtime to promote sleep. The nurse should plan to monitor the client for which of the following adverse effects?

• A. Ecchymosis
• B. Decreased urine output
• C. Increased blood pressure
• D. Dizziness

Correct answer: D

Rationale: The correct answer is D: Dizziness. Zolpidem is known to cause dizziness, especially in older adults. This adverse effect can increase the risk of falls and injuries in the elderly population. Monitoring for dizziness is crucial to ensure patient safety. Choice A, Ecchymosis, is the development of bruising and is not a common adverse effect of zolpidem. Choices B and C, Decreased urine output and Increased blood pressure, are not typically associated with zolpidem use. Therefore, they are incorrect choices in this scenario.

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