Nursing Elites

1. A client presenting with complaints of not feeling well is seen in a clinic. The client is taking several medications for the control of heart disease and hypertension, including a beta-blocker, digoxin (Lanoxin), and a diuretic. A tentative diagnosis of digoxin toxicity is made. Which of the following assessment data would support this diagnosis?

• A. Dyspnea, edema, and palpitations
• B. Chest pain, hypotension, and paresthesia
• C. Double vision, loss of appetite, and nausea
• D. Constipation, dry mouth, and sleep disorder

Correct answer: C

Rationale: The correct answer is C. Double vision, loss of appetite, and nausea are classic signs of digoxin toxicity. Other signs may include bradycardia, visual disturbances, and confusion. These symptoms are indicators that the client may be experiencing adverse effects due to elevated levels of digoxin in the system, requiring immediate medical attention to prevent serious complications.

2. Mycophenolate mofetil (CellCept) is prescribed for a client as prophylaxis for organ rejection following an allogeneic renal transplant. Which of the following instructions does the nurse reinforce regarding administration of this medication?

• A. Administer on an empty stomach.
• B. Take the medication with a calcium-type antacid.
• C. Open the capsule and mix with food for administration.
• D. Contact the health care provider (HCP) if a sore throat occurs.

Correct answer: D

Rationale: The correct instruction for administering mycophenolate mofetil (CellCept) is to contact the healthcare provider (HCP) if unusual bleeding or bruising, sore throat, or other adverse effects occur. It is essential not to open or crush the capsules to maintain the medication's efficacy.

3. Phenazopyridine hydrochloride (Pyridium) is prescribed for a client for symptomatic relief of pain resulting from a lower urinary tract infection. The nurse reinforces to the client:

• A. To take the medication after meals
• B. To take the medication before meals
• C. To discontinue the medication if a headache occurs
• D. That a reddish-orange discoloration of the urine may occur

Correct answer: D

Rationale: The nurse should instruct the client that a reddish-orange discoloration of urine may occur. The nurse should also educate the client that this discoloration can stain fabric. It is recommended to take the medication after meals to reduce the possibility of gastrointestinal upset. While a headache is an occasional side effect of the medication, it does not warrant discontinuation of the medication.

4. What instruction should be included in the client's teaching plan when prescribed montelukast (Singulair) for asthma?

• A. Take the medication as needed for asthma attacks.
• B. Take the medication in the evening.
• C. Increase fluid intake while taking this medication.
• D. Use the medication before exercise.

Correct answer: B

Rationale: The correct instruction to include in the teaching plan for a client prescribed montelukast (Singulair) is to take the medication in the evening. Montelukast is most effective when taken in the evening to provide optimal control of asthma symptoms. It is not intended for use as a rescue medication for asthma attacks. There is no specific recommendation to increase fluid intake or use the medication before exercise in relation to montelukast therapy.

5. A client with chronic pain is prescribed transdermal fentanyl (Duragesic) patches. Which instruction should the nurse include in the teaching plan?

• A. Apply the patch to a different site each time.
• B. Avoid using heating pads over the patch.
• C. Change the patch every 72 hours.
• D. Remove the old patch before applying the new one.

Correct answer: B

Rationale: Clients using transdermal fentanyl (Duragesic) patches should avoid using heating pads over the patch as heat can increase the release of the medication, potentially leading to overdose. The patch should be applied to a different site each time, changed every 72 hours, and the old patch should be removed before applying a new one to prevent accidental overdose or excessive drug absorption.

Similar Questions