Nursing Elites

1. A nurse is reviewing a client's medication regimen. Which of the following medications places the client at increased risk for digoxin toxicity?

• A. Calcium channel blockers
• B. Potassium-sparing diuretics
• C. Beta blockers
• D. Loop diuretics

Correct answer: D

Rationale: The correct answer is D, Loop diuretics. Loop diuretics can lead to hypokalemia, which increases the risk for digoxin toxicity. Loop diuretics cause potassium loss, and hypokalemia can potentiate the toxic effects of digoxin. Choices A, B, and C are incorrect because calcium channel blockers, potassium-sparing diuretics, and beta blockers do not directly increase the risk of digoxin toxicity.

2. A client prescribed lisinopril for hypertension may experience which of the following side effects that the nurse should monitor for?

• A. Cough
• B. Weight gain
• C. Dry mouth
• D. Hyperglycemia

Correct answer: A

Rationale: A persistent dry cough is a common side effect of lisinopril. Lisinopril is an ACE inhibitor that can cause a cough due to the accumulation of bradykinin. Weight gain, dry mouth, and hyperglycemia are not typically associated with lisinopril use, making them incorrect choices in this scenario.

3. A client with an artificial heart valve is prescribed warfarin therapy. Which of the following laboratory values should the nurse monitor to assess the therapeutic effect of warfarin?

• A. Hemoglobin (Hgb)
• B. Prothrombin time (PT)
• C. Bleeding time
• D. Activated partial thromboplastin time (aPTT)

Correct answer: B

Rationale: The correct answer is B: Prothrombin time (PT). Warfarin is an anticoagulant medication that works by inhibiting the clotting factors dependent on vitamin K, such as factors II, VII, IX, and X. The prothrombin time (PT) measures the extrinsic pathway and is used to monitor the therapeutic effects of warfarin therapy. Monitoring PT helps assess the time it takes for the blood to clot, ensuring that the anticoagulant effect is within the desired range. Choices A, C, and D are incorrect because hemoglobin (Hgb) measures the amount of hemoglobin in the blood, bleeding time assesses the time it takes for bleeding to stop, and activated partial thromboplastin time (aPTT) is used to monitor heparin therapy, not warfarin therapy.

4. A nurse has provided education to a client regarding prescribed levothyroxine sodium. Which of the following client statements demonstrates understanding of medication administration?

• A. I should take my medication as needed to alleviate symptoms
• B. I should take the medication in divided doses to ensure therapeutic drug levels
• C. I should take the medication in the morning to prevent insomnia
• D. I should take the medication on a full stomach

Correct answer: C

Rationale: Levothyroxine should be taken once in the morning to prevent insomnia and maintain therapeutic levels.

5. A 55-year-old client has levothyroxine ordered. Which of the below past medical history concerns may contraindicate with her medication management of hypothyroidism?

• A. Scleroderma
• B. Osteoporosis
• C. Asthma
• D. Peripheral Vascular Disease

Correct answer: B

Rationale: The correct answer is B: Osteoporosis. Osteoporosis is a concern with levothyroxine as it can increase the risk for fractures, particularly in older adults. Levothyroxine treatment can exacerbate bone loss in individuals with osteoporosis. Choices A, C, and D are not directly contraindicated with levothyroxine therapy for hypothyroidism.

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