Nursing Elites

1. When taking Digoxin, low levels of what can cause toxicity?

• A. Potassium
• B. Calcium
• C. Sodium
• D. Magnesium

Correct answer: A

Rationale: Low potassium levels can lead to Digoxin toxicity. Digoxin competes with potassium for binding sites on the sodium-potassium pump. When potassium levels are low, there is an increased risk of Digoxin binding and toxicity. Choice B (Calcium) is incorrect because low calcium levels are not directly linked to Digoxin toxicity. Choice C (Sodium) is incorrect as low sodium levels do not cause Digoxin toxicity. Choice D (Magnesium) is incorrect as low magnesium levels do not contribute to Digoxin toxicity.

2. What is levothyroxine's pharmacologic classification?

• A. Thyroid Preparations
• B. Metabolic Inhibitors
• C. Analgesic
• D. Loop Diuretic

Correct answer: A

Rationale: Levothyroxine is classified as a thyroid preparation because it is a synthetic form of the thyroid hormone thyroxine. It is primarily used to treat hypothyroidism by supplementing or replacing the natural thyroid hormones in the body, helping to regulate metabolism and energy levels. Choice B, Metabolic Inhibitors, is incorrect because levothyroxine does not inhibit metabolism but rather helps regulate it. Choice C, Analgesic, is incorrect as levothyroxine is not used for pain relief but for thyroid hormone replacement therapy. Choice D, Loop Diuretic, is also incorrect as loop diuretics are medications that act on the kidneys to increase urine production and are not related to thyroid hormone replacement therapy.

3. A client has a new prescription for a Nitroglycerin transdermal patch. Which of the following instructions should the nurse include?

• A. Apply the patch to the same site each day.
• B. Remove the patch at night.
• C. Cover the patch with a heating pad.
• D. Apply the patch to a hairless area of skin.

Correct answer: D

Rationale: The correct instruction is to apply the Nitroglycerin transdermal patch to a hairless area of skin. This ensures proper absorption of the medication. It is important to rotate the application site daily to prevent skin irritation and tolerance development. Applying the patch to the same site each day can lead to decreased efficacy and potential skin reactions. Removing the patch at night is not necessary as the patches are usually worn continuously to provide constant medication delivery. Covering the patch with a heating pad can increase the absorption of the medication and lead to an overdose, which is not recommended.

4. A client has been taking Sertraline for the past 2 days. Which of the following assessment findings should alert the nurse to the possibility that the client is developing Serotonin syndrome?

• A. Bruising
• B. Fever
• C. Abdominal pain
• D. Rash

Correct answer: B

Rationale: The correct answer is B: Fever. Fever is a key symptom of serotonin syndrome, a potentially life-threatening condition that can occur with the use of serotonergic medications like Sertraline. Serotonin syndrome is characterized by a combination of symptoms, including fever, agitation, rapid heartbeat, sweating, shivering, tremors, and in severe cases, it can lead to seizures, coma, and even death. Bruising (Choice A), abdominal pain (Choice C), and rash (Choice D) are not typically associated with serotonin syndrome. Therefore, the nurse should be vigilant in monitoring for fever as an early sign of serotonin syndrome in clients taking Sertraline.

5. A client has a prescription for Nitroglycerin, and a nurse is providing teaching. Which of the following instructions should the nurse include?

• A. Take one tablet every 15 minutes until pain is relieved.
• B. Take one tablet every 5 minutes, up to three doses.
• C. Take one tablet at bedtime.
• D. Take one tablet on an empty stomach.

Correct answer: B

Rationale: The correct instruction for taking Nitroglycerin is to take one tablet at the onset of chest pain, then repeat every 5 minutes for up to three doses. Option A is incorrect because taking a tablet every 15 minutes until pain is relieved may lead to delayed intervention. Option C is incorrect as taking Nitroglycerin at bedtime is not indicated for chest pain. Option D is incorrect as Nitroglycerin should be taken sublingually at the onset of chest pain, not on an empty stomach.

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