Nursing Elites

1. A healthcare provider is reviewing a client's medical history and notes that the client has a prescription for Digoxin. Which of the following findings is a manifestation of Digoxin toxicity?

• A. Elevated blood pressure
• B. Bradycardia
• C. Yellow-tinged vision
• D. Ringing in the ears

Correct answer: C

Rationale: Yellow-tinged vision, along with nausea, vomiting, and confusion, are common manifestations of Digoxin toxicity. Visual disturbances are important to recognize as they can indicate the need for immediate medical attention and potential adjustment of Digoxin therapy to prevent serious complications. Elevated blood pressure is not typically associated with Digoxin toxicity; instead, hypotension may occur. Bradycardia is a common therapeutic effect of Digoxin rather than a sign of toxicity. Ringing in the ears, or tinnitus, is also a potential side effect of Digoxin but is less specific to toxicity compared to yellow-tinged vision.

2. A client has a new prescription for Etanercept for Rheumatoid Arthritis. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will need to get my blood drawn periodically while on this medication.
• B. I should stop taking this medication if I develop a rash.
• C. I will need to limit my alcohol intake to no more than one drink per week.
• D. I should self-administer this medication subcutaneously.

Correct answer: A

Rationale: The correct answer is A because Etanercept can cause bone marrow suppression, so it is crucial to monitor blood counts regularly to detect any early signs of adverse effects.

3. A nurse is providing discharge instructions to a client who has a new prescription for a Fentanyl transdermal patch. Which of the following instructions should the nurse include?

• A. Apply the patch to a hairy area.
• B. Change the patch every 24 hours.
• C. Avoid exposure to heat sources.
• D. Cut the patch to adjust the dosage.

Correct answer: C

Rationale: The correct instruction that the nurse should include when providing discharge instructions for a client with a Fentanyl transdermal patch is to avoid exposure to heat sources. Heat can increase the absorption of the medication, leading to a risk of overdose. Choice A is incorrect because the patch should be applied to a clean, non-hairy area. Choice B is incorrect as the Fentanyl patch is usually changed every 72 hours, not every 24 hours. Choice D is incorrect as the patch should never be cut to adjust the dosage.

4. A client in labor is receiving IV Opioid analgesics. Which of the following actions should the nurse take?

• A. Instruct the client to self-ambulate every 2 hours.
• B. Offer oral hygiene every 2 hours.
• C. Anticipate medication administration 2 hours prior to delivery.
• D. Monitor fetal heart rate every 2 hours.

Correct answer: B

Rationale: When a client is receiving IV Opioid analgesics during labor, the nurse should offer oral hygiene every 2 hours. Opioid analgesics can cause adverse effects like dry mouth, nausea, and vomiting. Providing oral hygiene care helps alleviate these symptoms and maintains the client's comfort and well-being during labor. Instructing the client to self-ambulate every 2 hours is not appropriate during labor as mobility may be limited. Anticipating medication administration 2 hours prior to delivery is not necessary as the timing of medication administration should be based on the client's needs and the progress of labor. Monitoring fetal heart rate every 2 hours is important during labor, but it is not specifically related to the client receiving IV Opioid analgesics.

5. A client is reviewing a new prescription for Terbutaline with a history of preterm labor. Which of the following client statements indicates understanding of the teaching?

• A. I can increase my activity now that I've started on this medication.
• B. I will increase my daily fluid intake to 3 quarts.
• C. I will report increasing intensity of contractions to my doctor.
• D. I am glad this will prevent preterm labor.

Correct answer: C

Rationale: The correct answer is C. The client should report increasing intensity, frequency, or duration of contractions to the provider as these are signs of preterm labor. Monitoring contractions is crucial for the management of preterm labor and the safety of both the client and the fetus. Choices A, B, and D are incorrect because increasing activity, fluid intake, or assuming the medication will prevent preterm labor do not address the essential need to report changes in contractions, which are a vital sign of potential complications in preterm labor.

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