Nursing Elites

1. The LPN/LVN is assisting in caring for a client in the telemetry unit and is monitoring the client for cardiac changes indicative of hypokalemia. Which occurrence noted on the cardiac monitor indicates the presence of hypokalemia?

• A. Tall, peaked T waves
• B. ST-segment depression
• C. Prolonged P-R interval
• D. Widening of the QRS complex

Correct answer: B

Rationale: ST-segment depression can indicate hypokalemia, affecting the heart's electrical conduction. Hypokalemia leads to alterations in the repolarization phase of the cardiac action potential, resulting in ST-segment depression on the ECG. Tall, peaked T waves are indicative of hyperkalemia, not hypokalemia. A prolonged P-R interval is more commonly associated with first-degree heart block. Widening of the QRS complex is typically seen in conditions like bundle branch blocks or ventricular tachycardia, not specifically in hypokalemia.

2. A healthcare professional is assessing a client who has been taking isoniazid to treat tuberculosis. The healthcare professional should monitor the client for which of the following findings as an adverse effect of the medication?

• A. Diarrhea
• B. Blurred vision
• C. Hearing loss
• D. Jaundice

Correct answer: D

Rationale: Correct. Jaundice is a serious adverse effect of isoniazid due to liver damage. It is essential to monitor for signs of liver toxicity, such as jaundice, while the client is on this medication. Diarrhea is a common side effect of isoniazid, but it is not as serious as liver damage. Blurred vision and hearing loss are not typically associated with isoniazid use.

3. Before administering digoxin (Lanoxin) to a client diagnosed with heart failure, the nurse should perform which assessment?

• A. Check the blood pressure.
• B. Obtain an electrocardiogram (ECG).
• C. Assess the apical pulse.
• D. Review the latest electrolyte levels.

Correct answer: C

Rationale: Assessing the apical pulse is crucial before administering digoxin because the medication can lead to bradycardia. Monitoring the apical pulse helps determine the heart rate, and digoxin is typically withheld if the pulse is below 60 beats per minute. This assessment is essential to prevent potential adverse effects associated with digoxin administration. Checking the blood pressure (Choice A) is important but not specific to digoxin administration. Obtaining an electrocardiogram (ECG) (Choice B) may provide valuable information but is not the primary assessment needed before administering digoxin. Reviewing the latest electrolyte levels (Choice D) is important for assessing the overall condition but is not the immediate assessment required before administering digoxin.

4. A client with a diagnosis of heart failure is being discharged. What information should the nurse emphasize to the client regarding the use of a daily weight log?

• A. Report any weight gain of more than 2 pounds in a day
• B. Weigh yourself after eating breakfast each morning
• C. Use the same scale each day to check your weight
• D. Record your weight daily and report any changes

Correct answer: A

Rationale: The correct answer is A: 'Report any weight gain of more than 2 pounds in a day.' Sudden weight gain of more than 2 pounds in a day may indicate fluid retention and worsening heart failure. This information is crucial for early intervention and monitoring of the client's condition. Weighing after eating breakfast (choice B) may not provide consistent results due to varying food and fluid intake. Using the same scale each day (choice C) ensures accuracy and consistency in weight measurements. Recording weight daily (choice D) is more frequent than necessary and may not be practical for all clients. It is essential to focus on significant weight changes to prevent unnecessary alarm or confusion.

5. A healthcare professional is assessing a client who has a new prescription for furosemide. Which of the following findings should the healthcare professional report to the provider?

• A. Weight gain
• B. Dry cough
• C. Hypokalemia
• D. Increased appetite

Correct answer: C

Rationale: The correct answer is C: Hypokalemia. Hypokalemia is a common electrolyte imbalance associated with furosemide use due to its diuretic effect, which can lead to potassium loss. It is crucial to report hypokalemia promptly to the provider as it can result in serious complications such as cardiac arrhythmias. Monitoring and managing potassium levels are essential in patients taking furosemide to prevent adverse effects related to electrolyte imbalances. Choices A, B, and D are incorrect findings to report in a client prescribed furosemide. Weight gain is not typically associated with furosemide use, a dry cough is more commonly linked to ACE inhibitors, and increased appetite is not a common adverse effect of furosemide.

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