Nursing Elites

1. A client is taking Furosemide for heart failure. Which of the following findings is a priority to report to the provider?

• A. Weight loss of 1 kg in 24 hours
• B. Blood pressure of 104/60 mm Hg
• C. Potassium level of 3.5 mEq/L
• D. Urine output of 200 mL in 8 hours

Correct answer: D

Rationale: A urine output of 200 mL in 8 hours indicates decreased kidney function and potential worsening heart failure. This finding should be reported promptly to the provider for further evaluation and management to prevent complications. Weight loss, while significant, may be expected with diuretic use. A blood pressure of 104/60 mm Hg is within normal range and can be managed. A potassium level of 3.5 mEq/L is slightly low but not an immediate concern.

2. A client with Graves' disease is being educated by a nurse about her prescribed medications. Which of the following statements by the client indicates an understanding of the use of Propranolol in the treatment of Graves' disease?

• A. Propranolol helps increase blood flow to my thyroid gland.
• B. Propranolol is used to prevent excess glucose in my blood.
• C. Propranolol will decrease my tremors and fast heartbeat.
• D. Propranolol promotes a decrease of thyroid hormone in my body.

Correct answer: C

Rationale: The correct answer is C. Propranolol is a beta-adrenergic antagonist that is commonly used in Graves' disease to decrease symptoms such as tremors and fast heart rate. Choice A is incorrect because Propranolol does not increase blood flow to the thyroid gland. Choice B is incorrect as Propranolol is not used to prevent excess glucose in the blood. Choice D is also incorrect as Propranolol does not directly decrease thyroid hormone levels in the body.

3. A client has a new prescription for Digoxin to treat heart failure. Which of the following instructions should the nurse include in the teaching?

• A. Contact the provider if the heart rate is less than 60/min.
• B. Check the pulse rate for 30 seconds and multiply the result by 2.
• C. Increase the intake of sodium.
• D. Take with food if nausea occurs.

Correct answer: A

Rationale: The correct answer is A. It is crucial for clients on Digoxin to monitor their heart rate. A heart rate less than 60/min can indicate bradycardia, a potential side effect of Digoxin. Therefore, the client should be instructed to contact the provider if their heart rate is less than 60/min to prevent complications and receive appropriate management. Choices B, C, and D are incorrect. Checking the pulse rate for 30 seconds and multiplying by 2 is not specific to Digoxin administration. Increasing sodium intake is contraindicated as Digoxin can lead to sodium retention. Taking Digoxin with food if nausea occurs is not recommended as it may affect the drug's absorption.

4. A client has a new prescription for Verapamil to control hypertension. Which of the following instructions should the nurse include?

• A. Increase the amount of dietary fiber in the diet.
• B. Drink grapefruit juice daily to increase vitamin C intake.
• C. Decrease the amount of calcium in the diet.
• D. Withhold food for 1 hr after taking the medication.

Correct answer: A

Rationale: Increasing dietary fiber intake is essential when taking Verapamil to prevent constipation, a common adverse effect of this medication. Verapamil is a calcium channel blocker used to treat hypertension, and dietary fiber helps maintain bowel regularity and prevent constipation that may occur as a side effect of the medication.

5. A healthcare professional is preparing to administer an IV antibiotic to a client who has a systemic infection. Which of the following actions should the professional take first?

• A. Administer an antihistamine prior to the antibiotic.
• B. Monitor the client's urine output.
• C. Check the client's allergy history.
• D. Assess the client's vital signs.

Correct answer: C

Rationale: The first action the healthcare professional should take is to check the client's allergy history before administering the antibiotic to prevent a potential allergic reaction. It is crucial to identify any known allergies to antibiotics to ensure the client's safety and well-being. Administering an antihistamine prior to the antibiotic (Choice A) is not recommended unless an allergic reaction occurs. Monitoring the client's urine output (Choice B) and assessing the client's vital signs (Choice D) are important but not the first step in this situation. Checking the client's allergy history takes precedence to prevent adverse reactions.

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