Nursing Elites

1. A 6-month-old infant is prescribed digoxin for the treatment of congestive heart failure. Which observation by the practical nurse (PN) warrants immediate intervention for signs of digoxin toxicity?

• A. Apical heart rate of 60 beats/min
• B. Sweating across the forehead
• C. Poor sucking effort
• D. Respiratory rate of 30 breaths/min

Correct answer: A

Rationale: A heart rate of 60 beats/min for a 6-month-old infant warrants immediate intervention as it falls below the normal range. The normal heart rate for a 6-month-old is 80 to 150 beats/min when awake, and a rate of 70 beats/min while sleeping is considered within normal limits. Bradycardia (heart rate <60 beats/min) in infants can be a sign of digoxin toxicity, necessitating prompt evaluation and intervention to prevent adverse effects. Sweating across the forehead (Choice B) is a non-specific symptom and may not directly indicate digoxin toxicity. Poor sucking effort (Choice C) and a respiratory rate of 30 breaths/min (Choice D) are not typically associated with digoxin toxicity and do not require immediate intervention in the context of this question.

2. A client with schizophrenia is prescribed risperidone. Which statement by the client indicates the need for further teaching?

• A. I can stop taking this medication once I feel better.
• B. This medication may cause drowsiness.
• C. This medication might make me feel drowsy.
• D. I should avoid alcohol while taking this medication.

Correct answer: A

Rationale: Clients should not stop taking risperidone abruptly once they feel better without consulting their healthcare provider.

3. A client is prescribed methylprednisolone for an allergic reaction. The nurse should monitor for which potential side effect of this medication?

• A. Nausea and vomiting
• B. Weight gain
• C. Insomnia
• D. Increased appetite

Correct answer: B

Rationale: When a client is prescribed methylprednisolone, a corticosteroid, the nurse should monitor for weight gain as a potential side effect. Corticosteroids like methylprednisolone can cause weight gain and fluid retention due to their impact on metabolism and sodium retention. Nausea and vomiting are less common side effects of methylprednisolone. Insomnia and increased appetite are not typically associated with methylprednisolone use.

4. The healthcare professional is caring for a patient with a new order for an oral laxative. Which is a contraindication in administering an oral laxative?

• A. Cardiac problems
• B. Abdominal pain of unknown origin
• C. Several hemorrhoids
• D. Chronic constipation

Correct answer: B

Rationale: Administering an oral laxative to a patient with abdominal pain of unknown origin is contraindicated because it could be a sign of a more serious underlying condition that needs immediate medical evaluation. Giving a laxative in such a situation without proper diagnosis could potentially worsen the patient's condition or delay appropriate treatment. Choice A (Cardiac problems) is not a contraindication for an oral laxative unless the patient has a specific cardiac condition that interacts with the laxative. Choice C (Several hemorrhoids) and Choice D (Chronic constipation) are not contraindications for administering an oral laxative.

5. A client with a history of deep vein thrombosis is prescribed dabigatran. The nurse should monitor for which potential adverse effect?

• A. Bleeding
• B. Weight gain
• C. Headache
• D. Nausea

Correct answer: A

Rationale: Dabigatran is an anticoagulant that increases the risk of bleeding. Therefore, the nurse should closely monitor the client for signs of bleeding, such as easy bruising, blood in the urine or stool, prolonged bleeding from cuts, or nosebleeds, to ensure early detection and intervention.

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