Nursing Elites

1. The client on digoxin has a potassium level of 3.0 mEq/L. What is the nurse’s priority action?

• A. Administer a potassium supplement
• B. Hold the digoxin and notify the healthcare provider
• C. Continue the current digoxin dose
• D. Administer Digibind

Correct answer: B

Rationale: The correct answer is to hold the digoxin and notify the healthcare provider. A potassium level of 3.0 mEq/L indicates hypokalemia, which can increase the risk of digoxin toxicity. Digoxin and low potassium levels can lead to serious cardiac arrhythmias. Administering a potassium supplement (choice A) without healthcare provider guidance can worsen the situation. Continuing the current digoxin dose (choice C) can further increase the risk of toxicity. Administering Digibind (choice D) is used in severe cases of digoxin toxicity, not for addressing low potassium levels.

2. When administering enoxaparin (Lovenox) to a client for DVT prophylaxis, what is the most important lab value to monitor?

• A. Platelet count
• B. PT/INR
• C. aPTT
• D. Hemoglobin

Correct answer: A

Rationale: The correct answer is A: Platelet count. When administering enoxaparin (Lovenox) for DVT prophylaxis, it is crucial to monitor the platelet count as enoxaparin can lead to thrombocytopenia, a decrease in platelet levels. Monitoring the platelet count helps in early detection of this potential adverse effect. Choices B, C, and D are incorrect because PT/INR, aPTT, and hemoglobin levels are not the most important lab values to monitor specifically for enoxaparin administration and DVT prophylaxis.

3. The nurse is administering digoxin to a client. What is the most important parameter to check before administration?

• A. Heart rate
• B. Blood pressure
• C. Respiratory rate
• D. Oxygen saturation

Correct answer: A

Rationale: The correct answer is A: Heart rate. Before administering digoxin, it is crucial to check the client's heart rate because digoxin can cause bradycardia, making it essential to ensure the heart rate is within the appropriate range. Blood pressure, respiratory rate, and oxygen saturation are also important parameters to monitor in a clinical setting, but when administering digoxin, the focus should primarily be on the heart rate due to its potential effects on cardiac function.

4. A client on an ACE inhibitor reports a persistent cough. What is the nurse’s best response?

• A. Reassure the client that the cough is a common side effect and is usually not serious.
• B. Instruct the client to report the cough to the healthcare provider as it may require discontinuation of the medication.
• C. Advise the client to use a humidifier at night to relieve the cough.
• D. Suggest the client take an over-the-counter cough suppressant.

Correct answer: B

Rationale: The correct answer is B. A persistent cough in a client on an ACE inhibitor may indicate a serious side effect that requires discontinuation of the medication. Instructing the client to report the cough to the healthcare provider is essential for proper evaluation and management. Choice A is incorrect because simply reassuring the client may delay necessary action. Choice C is incorrect as using a humidifier may not address the underlying cause of the cough. Choice D is incorrect because taking a cough suppressant without healthcare provider guidance may mask symptoms without addressing the cause.

5. Which of the following is a chronic lung disease that results in the gradual destruction of the alveoli, causing difficulty breathing and reduced oxygen exchange?

• A. Emphysema
• B. Bronchitis
• C. Pulmonary hypertension
• D. Sarcoidosis

Correct answer: A

Rationale: Emphysema is the correct answer as it is a chronic lung disease characterized by the gradual destruction of the alveoli, which are essential for oxygen exchange. This destruction leads to difficulty breathing and reduced oxygen levels in the blood. Bronchitis is an inflammation of the bronchial tubes, not specifically involving alveoli destruction. Pulmonary hypertension is a condition of high blood pressure in the arteries of the lungs, not directly related to alveoli destruction. Sarcoidosis is a disease characterized by the growth of tiny collections of inflammatory cells in different parts of the body, including the lungs, but it does not primarily involve the destruction of alveoli.

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