Nursing Elites

1. While reviewing a client's medical history, a healthcare professional notes a prescription for Digoxin. Which of the following findings is a manifestation of Digoxin toxicity?

• A. Elevated blood pressure
• B. Bradycardia
• C. Yellow-tinged vision
• D. Ringing in the ears

Correct answer: C

Rationale: Yellow-tinged vision is a visual disturbance associated with Digoxin toxicity, often accompanied by other symptoms like nausea, vomiting, and confusion. Bradycardia is a common therapeutic effect of Digoxin, while elevated blood pressure and ringing in the ears are not typically associated with Digoxin toxicity. Therefore, the correct answer is yellow-tinged vision as a manifestation of Digoxin toxicity.

2. A healthcare professional is preparing to administer Filgrastim for the first time to a client who has just undergone a bone marrow transplant. Which of the following interventions is appropriate?

• A. Administer intravenously to prevent injury.
• B. Ensure that the medication is kept refrigerated until just prior to administration.
• C. Do not shake the vial; gently invert it to mix before withdrawing the dose.
• D. Discard the vial after removing one dose of the medication.

Correct answer: D

Rationale: When administering Filgrastim, only one dose should be withdrawn from the vial, and the vial should then be discarded to prevent any contamination or errors in dosing. It is crucial not to shake the vial but gently invert it to mix the medication before withdrawing the appropriate dose. Refrigeration is not required for Filgrastim; it should be stored at room temperature until just before administration. Choice A is incorrect because Filgrastim is typically administered subcutaneously, not intravenously. Choice B is incorrect as the medication should be stored at room temperature, not refrigerated, until administration. Choice C is incorrect as shaking the vial is not recommended for Filgrastim.

3. A client has a new prescription for Enalapril. Which of the following adverse effects should the nurse instruct the client to monitor?

• A. Dry cough.
• B. Hyperglycemia.
• C. Weight gain.
• D. Increased urination.

Correct answer: A

Rationale: The correct answer is A: Dry cough. A common adverse effect of Enalapril, an ACE inhibitor, is a persistent dry cough. This occurs due to the accumulation of bradykinin. It is essential for the client to monitor for this side effect and report it to their healthcare provider promptly. Choices B, C, and D are incorrect because hyperglycemia, weight gain, and increased urination are not typically associated with Enalapril use.

4. When teaching a client with a new prescription for Lisinopril, which instruction should the nurse include?

• A. Take the medication with food.
• B. Expect a persistent, dry cough.
• C. Increase your intake of potassium-rich foods.
• D. Take the medication at bedtime.

Correct answer: B

Rationale: The correct answer is B: 'Expect a persistent, dry cough.' Lisinopril, an ACE inhibitor, commonly causes a persistent, dry cough as a side effect. This should be reported to the healthcare provider if it becomes bothersome. It is essential for the nurse to educate the client about this potential side effect so the client is aware and can seek appropriate guidance if needed. Choices A, C, and D are incorrect. Taking Lisinopril with food is not required. Increasing potassium-rich foods is not a specific instruction for Lisinopril, and taking the medication at bedtime is not a typical recommendation associated with this medication.

5. A client is receiving epoetin alfa to treat anemia. Which of the following findings should the nurse monitor?

• A. Leukocytosis
• B. Hypertension
• C. Hyperkalemia
• D. Fever

Correct answer: B

Rationale: The nurse should monitor the client for hypertension when receiving epoetin alfa. Epoetin alfa stimulates red blood cell production, which can lead to increased blood pressure. Monitoring blood pressure is crucial to detect and manage hypertension promptly. Leukocytosis refers to an increased white blood cell count and is not directly related to epoetin alfa treatment. Hyperkalemia is an elevated potassium level, which is not a common adverse effect of epoetin alfa. Fever is not a typical finding associated with epoetin alfa therapy.

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