Nursing Elites

1. The LPN/LVN is assisting in the care of a client with chronic heart failure who is receiving digoxin (Lanoxin). Which sign should the nurse monitor for that could indicate digoxin toxicity?

• A. Bradycardia
• B. Tachycardia
• C. Hypertension
• D. Hyperglycemia

Correct answer: A

Rationale: Bradycardia is a common sign of digoxin toxicity and should be closely monitored. Digoxin toxicity can lead to various cardiac dysrhythmias, with bradycardia being a significant indicator. Monitoring the client's heart rate is crucial to detect and manage digoxin toxicity promptly. Tachycardia, hypertension, and hyperglycemia are not typically associated with digoxin toxicity. Tachycardia is more commonly seen with inadequate treatment of heart failure, hypertension is a possible but less common effect, and hyperglycemia is not a typical sign of digoxin toxicity.

2. After a client with a history of myocardial infarction (MI) is prescribed aspirin, which instruction should the nurse include in the discharge teaching?

• A. Take the aspirin with food to prevent gastrointestinal upset
• B. Discontinue the aspirin if you experience ringing in your ears
• C. Take the aspirin at bedtime to minimize side effects
• D. Avoid taking aspirin if you are also taking other NSAIDs

Correct answer: A

Rationale: The correct instruction is to take aspirin with food to prevent gastrointestinal upset. Aspirin can irritate the stomach lining, leading to potential gastrointestinal issues. Taking it with food helps reduce this risk by providing a protective layer in the stomach. This is a common recommendation to minimize the risk of gastrointestinal side effects when taking aspirin. Choices B, C, and D are incorrect. Choice B is not a typical reason to discontinue aspirin, as ringing in the ears is not a common side effect of aspirin. Choice C does not have a direct correlation to minimizing side effects of aspirin. Choice D is inaccurate because while caution should be exercised when taking aspirin with other NSAIDs due to the increased risk of bleeding, it does not mean aspirin should be entirely avoided if other NSAIDs are being taken.

3. A client with a history of coronary artery disease (CAD) is being discharged with a prescription for aspirin. Which instruction should the nurse reinforce with the client?

• A. Take the aspirin on an empty stomach for better absorption.
• B. Stop taking the aspirin if you experience any stomach discomfort.
• C. Take the aspirin with food to reduce the risk of stomach irritation.
• D. Take the aspirin only when you have chest pain.

Correct answer: C

Rationale: The correct instruction is to take the aspirin with food to reduce the risk of stomach irritation. This is crucial for clients with a history of coronary artery disease as it helps minimize gastrointestinal side effects like irritation and bleeding. Option A is incorrect because aspirin should not be taken on an empty stomach to prevent stomach upset. Option B is incorrect because discontinuing aspirin at the first sign of stomach discomfort can be harmful, and a healthcare provider should be consulted instead. Option D is incorrect because aspirin is often prescribed for prevention in cardiovascular conditions, not just for chest pain relief.

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

• A. Weight gain
• B. Increased heart rate
• C. Heat intolerance
• D. Elevated blood pressure

Correct answer: C

Rationale: The correct answer is C: Heat intolerance. Heat intolerance is a concerning sign of levothyroxine toxicity and should be reported to the provider promptly. Levothyroxine is a medication used to treat hypothyroidism by supplementing the body's thyroid hormones. When a client experiences heat intolerance, it can indicate that the dose of levothyroxine is too high, leading to hyperthyroidism symptoms. Weight gain, increased heart rate, and elevated blood pressure are not typically associated with levothyroxine toxicity; instead, they are more commonly seen in conditions like hypothyroidism.

5. The client has been prescribed warfarin (Coumadin) and is being educated about dietary restrictions. Which food should the client be advised to avoid or eat in consistent amounts?

• A. Bananas
• B. Spinach
• C. Oranges
• D. Yogurt

Correct answer: B

Rationale: Spinach is high in vitamin K, which can interfere with the effectiveness of warfarin. It is important for clients taking warfarin to maintain consistent levels of vitamin K intake to ensure the medication works properly. Foods rich in vitamin K, such as spinach, can counteract the effects of warfarin, leading to potential complications. Therefore, clients on warfarin are advised to either avoid or consume vitamin K-rich foods, like spinach, in consistent amounts to maintain the medication's efficacy. Bananas, oranges, and yogurt are not high in vitamin K and do not significantly impact the effectiveness of warfarin, making them safe options for clients taking this medication.

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