Nursing Elites

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

Correct answer: A

Rationale: The correct instruction for a client prescribed Digoxin for heart failure is to contact the provider if the heart rate is less than 60/min. Digoxin can affect heart rate, and a heart rate below 60/min may indicate toxicity, requiring prompt medical attention. Checking the pulse rate accurately and seeking medical advice are essential components of safe medication management. Choices B, C, and D are incorrect. Choice B is related to checking the pulse rate but does not address the critical action of contacting the provider if it is below 60/min. Increasing intake of sodium (Choice C) is inappropriate as high sodium levels can worsen heart failure. Taking Digoxin with food if nausea occurs (Choice D) does not address a critical aspect of Digoxin administration related to heart rate monitoring.

2. A client is prescribed Propylthiouracil (PTU) for the treatment of Graves' disease. Which adverse effect should the client be instructed to report?

• A. Sore throat.
• B. Drowsiness.
• C. Urinary retention.
• D. Heat intolerance.

Correct answer: A

Rationale: The correct answer is A: Sore throat. A sore throat and fever can indicate agranulocytosis, a serious adverse effect of PTU that can lead to a decreased white blood cell count. This condition requires immediate medical attention to prevent complications. Choice B, drowsiness, is not typically associated with PTU and is not a common adverse effect that needs to be reported. Choice C, urinary retention, is not a typical adverse effect of PTU; therefore, it is not the correct answer. Choice D, heat intolerance, is a symptom commonly seen in hyperthyroidism, which PTU is used to treat, so it is not an adverse effect that needs to be specifically reported.

3. A healthcare professional is preparing to administer eye drops to a client. Which of the following actions should the healthcare professional take? (Select all that apply.)

• A. Have the client lie on their side.
• B. Ask the client to look up at the ceiling.
• C. Tell the client to blink when the drops enter their eye.
• D. Drop the medication into the center of the client's conjunctival sac.

Correct answer: B

Rationale: When administering eye drops, it is essential to ask the client to look up at the ceiling. This position helps prevent the drops from falling onto the cornea, ensuring that the medication is properly absorbed without causing discomfort or irritation.

4. A client is starting a new prescription for enalapril. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Rise slowly from a sitting position.
• C. Avoid salt substitutes.
• D. Avoid exposure to sunlight.

Correct answer: C

Rationale: The correct instruction for a client starting enalapril is to avoid salt substitutes. Salt substitutes may contain potassium, which could lead to elevated potassium levels when combined with enalapril, increasing the risk of hyperkalemia. Choices A, B, and D are incorrect because there is no specific need to take enalapril with food, rise slowly from a sitting position, or avoid exposure to sunlight when taking this medication.

5. Which of the following is not a side effect of the cholinoreceptor blocker (Atropine)?

• A. Increased pulse
• B. Diarrhea
• C. Constipation
• D. Mydriasis

Correct answer: B

Rationale: Atropine, an anticholinergic drug, commonly causes side effects like increased pulse, mydriasis (dilated pupils), and constipation due to its inhibitory effect on the parasympathetic nervous system. Diarrhea is not typically a side effect of Atropine, making it the correct answer.

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