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 nurse is teaching a client who 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 into the muscle.'

Correct answer: A

Rationale: Etanercept can cause bone marrow suppression, so it is important to monitor blood counts regularly.

3. Following a stroke, a client has been started on clopidogrel (Plavix). Why is this medication being administered?

• A. To prevent stroke in high-risk patients, such as those with prosthetic heart valves
• B. To decrease blood pressure
• C. To increase heart rate
• D. To provide antiplatelet activity in patients who cannot tolerate aspirin

Correct answer: D

Rationale: Clopidogrel (Plavix) is an antiplatelet medication that inhibits platelet aggregation, reducing the risk of blood clots. It is commonly used in patients who have had a stroke and cannot tolerate aspirin due to allergies or intolerances. Choosing clopidogrel in these cases helps prevent further clot formation and reduces the risk of recurrent strokes.

4. When administering the drug senna to a patient, what must a health care provider inform the patient of?

• A. This drug is intended to lower blood pressure and is best used in combination with other antihypertensives
• B. This drug is not intended for long-term use
• C. The patient must limit his/her fiber intake
• D. Advise the patient to change positions slowly to limit the risk of orthostatic hypotension

Correct answer: B

Rationale: The correct answer is B. Senna is a laxative used for short-term relief of constipation, not for long-term use. Choice A is incorrect because senna does not lower blood pressure or require combination with antihypertensives. Choice C is unrelated as there is no need to limit fiber intake with senna. Choice D is incorrect as orthostatic hypotension is not a common concern with senna use.

5. Phenytoin is an antiarrhythmic and anticonvulsant that has an unlabeled use for:

• A. Headaches
• B. Cold remedy
• C. Neuropathic pain
• D. Antianxiety

Correct answer: C

Rationale: Phenytoin, an antiarrhythmic and anticonvulsant medication, is also used off-label for treating neuropathic pain. While its primary indications are for managing heart rhythm disorders and seizures, it has shown efficacy in managing neuropathic pain, expanding its clinical utility. Choices A, B, and D are incorrect as phenytoin is not commonly used for headaches, cold remedies, or antianxiety purposes.

Similar Questions