Nursing Elites

1. Phenytoin is an antiarrhythmic and anticonvulsant that has an unlabeled use for:

• A. Headaches
• B. Cold remedy
• C. Neuropathic pain
• D. Antianxiety

Correct answer: C

Rationale: Phenytoin, an antiarrhythmic and anticonvulsant medication, is also used off-label for treating neuropathic pain. While its primary indications are for managing heart rhythm disorders and seizures, it has shown efficacy in managing neuropathic pain, expanding its clinical utility. Choices A, B, and D are incorrect as phenytoin is not commonly used for headaches, cold remedies, or antianxiety purposes.

2. A client is prescribed Atorvastatin. Which of the following laboratory values should be monitored to assess for potential adverse effects?

• A. Blood glucose
• B. Creatine kinase
• C. Hemoglobin
• D. Sodium

Correct answer: B

Rationale: Creatine kinase should be monitored in clients taking Atorvastatin as it can indicate muscle damage, a serious adverse effect of statins. Elevated creatine kinase levels can suggest myopathy or rhabdomyolysis, which are potential complications associated with statin therapy. Monitoring creatine kinase levels helps in early detection of muscle damage and guides appropriate management to prevent severe complications.

3. When providing discharge instructions to a client prescribed Prednisone, which of the following dietary instructions should the nurse include?

• A. Increase your intake of potassium-rich foods.
• B. Increase your intake of dairy products.
• C. Avoid foods high in vitamin K.
• D. Decrease your intake of protein.

Correct answer: A

Rationale: The correct answer is to instruct the client to increase their intake of potassium-rich foods. Prednisone can lead to potassium depletion, making it essential to consume foods high in potassium, such as bananas, oranges, and spinach, to maintain electrolyte balance and prevent complications. Choice B is incorrect because increasing dairy products is not specifically necessary when taking Prednisone. Choice C is wrong as foods high in vitamin K are not contraindicated with Prednisone. Choice D is incorrect as there is no need to decrease protein intake when prescribed Prednisone.

4. A client presents in the Emergency Department with chest pain. Which of the following conditions is least likely to cause chest pain?

• A. Arthritis
• B. Peptic ulcer disease
• C. Myocardial infarction
• D. Gastric reflux

Correct answer: A

Rationale: Arthritis is a condition primarily affecting the joints and is not known to cause chest pain. Peptic ulcer disease, myocardial infarction, and gastric reflux are conditions that can present with chest pain due to various reasons such as inflammation, ischemia, or reflux of stomach acid into the esophagus, respectively.

5. A client with congestive heart failure taking digoxin refused breakfast and is complaining of nausea and weakness. Which action should the nurse take first?

• A. Check the client's vital signs.
• B. Request a consult with a dietitian.
• C. Suggest that the client rests before eating the meal.
• D. Request an order for an antiemetic.

Correct answer: A

Rationale: The nurse should check the client's vital signs first because nausea and weakness can be signs of digoxin toxicity. Vital signs can provide immediate information on the client's condition and help guide further interventions. Monitoring vital signs will allow the nurse to assess for bradycardia, a common sign of digoxin toxicity. Requesting a dietitian consult (choice B) may be necessary but addressing the immediate concern of toxicity is the priority. Suggesting rest before eating (choice C) may not address the underlying issue of digoxin toxicity. Requesting an antiemetic (choice D) can be considered later but is not the initial action needed in this situation.

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