Nursing Elites

1. The nurse is providing discharge teaching to a client who has a new prescription for digoxin (Lanoxin). Which statement by the client indicates a need for further teaching?

• A. I will take my pulse before taking the medication.
• B. I will take the medication at the same time every day.
• C. I should avoid taking antacids at the same time as this medication.
• D. I should eat foods high in potassium while taking this medication.

Correct answer: D

Rationale: The correct answer is D. Clients taking digoxin should avoid eating foods high in potassium, as this can affect the medication's efficacy. Choices A, B, and C are correct statements regarding digoxin administration and precautions, indicating the client's understanding of the medication and its management.

2. A client receives the influenza vaccine in a clinic. Within 15 minutes after the immunization, the client complains of itchy and watery eyes, increased anxiety, and difficulty breathing. What should be the first action in the sequence of care for this client?

• A. Maintain the airway
• B. Administer epinephrine 1:1000 as ordered
• C. Monitor for hypotension with shock
• D. Administer diphenhydramine as ordered

Correct answer: B

Rationale: In the scenario described, the client is experiencing symptoms of an anaphylactic reaction, a severe allergic response. The priority action in an anaphylactic reaction is to administer epinephrine. Epinephrine helps counteract the severe allergic response, improves breathing difficulties, and maintains airway and circulation. Administering epinephrine takes precedence to stabilize the client's condition. Options A, C, and D may be necessary in the management of anaphylaxis, but the immediate priority is to administer epinephrine to address the life-threatening symptoms.

3. A child weighing 20 kg has a new prescription for cefoxitin at 80 mg/kg/day administered intravenously every 6 hours. How much cefoxitin should be administered with each dose?

• A. 400 mg
• B. 200 mg
• C. 1600 mg
• D. 100 mg

Correct answer: A

Rationale: To determine the amount of cefoxitin to be administered with each dose, first, calculate the total daily dose by multiplying the child's weight (20 kg) by the prescribed dose (80 mg/kg/day): 80 mg/kg/day × 20 kg = 1600 mg/day. Since the medication is administered every 6 hours (4 doses/day), divide the total daily dose by the number of doses: 1600 mg / 4 = 400 mg. Therefore, each dose should be 400 mg. Choice B (200 mg) is incorrect because it is half the calculated dose. Choice C (1600 mg) is incorrect as it represents the total daily dose, not the dose per administration. Choice D (100 mg) is incorrect as it is a quarter of the calculated dose.

4. When developing a plan of care for a client with dementia, what should the LPN/LVN remember about confusion in the elderly?

• A. It is not a normal part of aging.
• B. It often follows relocation to new surroundings.
• C. It is primarily due to changes in the brain associated with the disease.
• D. It cannot be prevented or cured by adequate sleep alone.

Correct answer: B

Rationale: When caring for a client with dementia, it is crucial to understand that confusion often arises after relocating to new surroundings. This change can disrupt familiar routines and trigger increased disorientation and confusion. Choice A is correct because confusion in the elderly is not a normal part of aging. Choice C is incorrect because confusion in dementia is primarily due to changes in the brain associated with the disease, not just irreversible brain pathology. Choice D is incorrect because while adequate sleep is important for overall health, it alone cannot prevent or cure confusion associated with dementia.

5. A 3-year-old child is brought to the clinic by his grandmother to be seen for 'scratching his bottom and wetting the bed at night.' Based on these complaints, the nurse would initially assess for which problem?

• A. Allergies
• B. Scabies
• C. Regression
• D. Pinworms

Correct answer: D

Rationale: The correct answer is D, Pinworms. Pinworms are a common cause of itching around the anal area, especially at night, in young children. Scratching the bottom and bedwetting can be indicative of a pinworm infection. Allergies (Choice A) are less likely given the symptoms described. Scabies (Choice B) may cause itching but is less common in causing bedwetting. Regression (Choice C) is not a common cause of these specific symptoms in a 3-year-old child.

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