Nursing Elites

1. A healthcare provider is caring for a client who is prescribed Digoxin. Which of the following laboratory values should the provider monitor to assess for potential toxicity?

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

Correct answer: B

Rationale: The correct answer is to monitor the client's potassium levels. Hypokalemia can increase the risk of Digoxin toxicity. Potassium levels should be closely monitored to prevent adverse effects. Monitoring sodium levels is not directly related to Digoxin toxicity. While magnesium and calcium are important electrolytes, potassium levels are more critical for Digoxin toxicity assessment.

2. A client has a new prescription for Digoxin for heart failure. Which of the following adverse effects should the client be instructed to monitor for and report to the provider?

• A. Dry cough
• B. Pedal edema
• C. Bruising
• D. Yellow-tinged vision

Correct answer: D

Rationale: Yellow-tinged vision is a potential adverse effect of digoxin, which may indicate toxicity. It is crucial for the client to report this symptom promptly to the healthcare provider to prevent any further complications. Dry cough is not typically associated with digoxin use. Pedal edema is a common symptom of heart failure, which digoxin is prescribed to manage. Bruising is not a common adverse effect of digoxin.

3. A client with Addison's disease is being admitted for a total hip arthroplasty. The client takes hydrocortisone for Addison's disease. What is the nurse's priority action?

• A. Administering a supplemental dose of hydrocortisone
• B. Instructing the client about coughing and deep breathing
• C. Collecting additional information from the client about his history of Addison's disease
• D. Inserting an indwelling urinary catheter

Correct answer: A

Rationale: The nurse's priority in this situation is to administer a supplemental dose of hydrocortisone. Clients with Addison's disease taking hydrocortisone are at risk of acute adrenal insufficiency during times of stress such as surgery. Administering supplemental doses of hydrocortisone helps prevent acute adrenal insufficiency (adrenal crisis) in these situations, making it the priority action to ensure the client's safety. Instructing the client about coughing and deep breathing is important postoperatively but not the priority at this time. Collecting additional information about the client's history of Addison's disease is important but not the priority action before surgery. Inserting an indwelling urinary catheter is not the priority in this situation.

4. A client with increased liver enzymes is taking herbal supplements. Which of the following herbal supplements should the nurse report to the provider?

• A. Glucosamine
• B. Saw palmetto
• C. Kava
• D. St. John's wort

Correct answer: C

Rationale: The nurse should report kava to the provider because chronic use or high doses of kava can lead to liver damage, including severe liver failure. It is crucial for the nurse to be vigilant about any herbal supplement that could potentially worsen the client's liver condition.

5. A client prescribed Warfarin is receiving discharge instructions from a nurse. Which of the following dietary instructions should the nurse include?

• A. Increase your intake of leafy green vegetables.
• B. Avoid foods high in vitamin K.
• C. Increase your intake of dairy products.
• D. Avoid foods high in iron.

Correct answer: B

Rationale: The correct answer is B: 'Avoid foods high in vitamin K.' Vitamin K can interfere with the effectiveness of Warfarin, an anticoagulant medication. Foods high in vitamin K, such as leafy green vegetables, can reduce the medication's anticoagulant effect. Therefore, clients taking Warfarin should be advised to avoid or consume a consistent amount of foods high in vitamin K to maintain the medication's effectiveness. Choices A, C, and D are incorrect because increasing leafy green vegetables, dairy products, or avoiding foods high in iron are not directly related to the interaction with Warfarin.

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