Nursing Elites

1. The nurse is preparing to administer a daily dose of digoxin. What is the priority nursing intervention?

• A. Analyze HR and rhythm
• B. Assess for Homan�s sign
• C. Check BP
• D. Palpate the pedal pulses

Correct answer: A

Rationale: Before giving digoxin, the nurse will assess the HR and rhythm. The dosage will be held and the prescriber notified if the HR is below 60 bpm or if the cardiac rhythm has changes. Digoxin can cause bradycardia and electrical changes in the heart.

2. A patient is prescribed fluconazole (Diflucan) for a vaginal yeast infection. The nurse should be concerned if the patient is also taking which medication?

• A. Losartan (Cozaar)
• B. Simvastatin (Zocor)
• C. Lisinopril (Zestril)
• D. Hydrochlorothiazide (HCTZ)

Correct answer: B

Rationale: When fluconazole is taken with statins like simvastatin, it can increase the levels of the statin in the blood, potentially leading to adverse effects such as muscle pain and weakness. Therefore, the nurse should be concerned if the patient is taking simvastatin along with fluconazole.

3. A patient is taking a first-generation H1 blocker for the treatment of allergic rhinitis. It is most important for the nurse to assess for which adverse effect?

• A. Skin flushing
• B. Wheezing
• C. Insomnia
• D. Dry mouth

Correct answer: D

Rationale: Adverse Effect of Histamine � First Generation H1 blockers include dry mouth.

4. When teaching a school-age child and the parent how to administer insulin, which of the following instructions should the nurse include?

• A. Store the insulin in the refrigerator after each use.
• B. Rotate injection sites each time you give the injection.
• C. You should give the insulin at room temperature.
• D. Administer the insulin within 30 minutes of each meal.

Correct answer: C

Rationale: It is essential to give insulin at room temperature to prevent discomfort during administration. Cold insulin can cause stinging and pain, which can be avoided by allowing the insulin to reach room temperature before administration. Storing insulin in the refrigerator is correct for long-term storage, but it should be brought to room temperature before use. Rotating injection sites is important to prevent lipohypertrophy, a condition characterized by fatty lumps that can develop if injections are consistently given in the same area. Administering insulin within 30 minutes of a meal is generally recommended to match the insulin peak action with the peak glucose levels after eating, but giving insulin at room temperature is more crucial to ensure comfort and proper absorption.

5. A parent tells the nurse that her child is scheduled for an x-ray of the bladder and urethra that is done while the child is urinating. What is this test known as?

• A. Cystometrogram
• B. Cystoscopy
• C. Voiding cystourethrogram
• D. Intravenous pyelogram

Correct answer: C

Rationale: The correct test for an x-ray examination of the bladder and urethra before and during micturition is a voiding cystourethrogram. This procedure allows visualization of the bladder and urethra while the patient is urinating to assess for any abnormalities in the anatomy or function of these structures.

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