Nursing Elites

1. A client is prescribed digoxin 0.125 mg daily for heart failure. Which of the following client reports should concern the nurse as a sign of digoxin toxicity?

• A. Increased appetite
• B. Visual disturbances
• C. Weight gain
• D. Constipation

Correct answer: B

Rationale: Visual disturbances such as blurred vision or seeing halos around lights are common signs of digoxin toxicity. Increased appetite, weight gain, and constipation are not typically associated with digoxin toxicity. Weight gain could be a sign of worsening heart failure rather than digoxin toxicity. Increased appetite and constipation are not specific signs of digoxin toxicity and are less likely to be related.

2. A client is prescribed HMG CoA reductase inhibitor, atorvastatin. Which of the following should be monitored while this medication is prescribed?

• A. Liver function tests
• B. Renal function tests
• C. Visual acuity screening
• D. Hearing screenings

Correct answer: A

Rationale: The correct answer is A: Liver function tests. Atorvastatin, an HMG CoA reductase inhibitor, can lead to hepatotoxicity, making it essential to monitor liver function tests regularly. Choices B, C, and D are incorrect because atorvastatin primarily affects the liver, not the kidneys, vision, or hearing.

3. A nurse is preparing to administer morphine sulfate 2 mg IV bolus. Available is morphine sulfate 10 mg/mL. How many mL should the nurse administer per dose?

• A. 0.2 mL
• B. 0.4 mL
• C. 0.6 mL
• D. 0.8 mL

Correct answer: A

Rationale: The nurse should administer 0.2 mL of morphine sulfate. To calculate this, divide the desired dose (2 mg) by the concentration of the available solution (10 mg/mL). 2 mg / 10 mg/mL = 0.2 mL. Therefore, the nurse should administer 0.2 mL of morphine sulfate. Choices B, C, and D are incorrect as they do not reflect the accurate calculation based on the provided concentration and desired dose.

4. A nurse is preparing to administer an intramuscular injection to an adult client. At what angle should the nurse administer the medication using the ventrogluteal site?

• A. a 45-degree angle
• B. a 60-degree angle
• C. a 75-degree angle
• D. a 90-degree angle

Correct answer: D

Rationale: Intramuscular injections in the ventrogluteal site should be administered at a 90-degree angle. This angle ensures that the medication reaches the muscle tissue effectively. Angles less than 90 degrees can cause subcutaneous injection instead of intramuscular, leading to slower absorption of the medication. Angles greater than 90 degrees risk hitting bone or nerves, causing unnecessary pain or injury. Therefore, the correct angle for administering intramuscular injections in the ventrogluteal site is 90 degrees.

5. A nurse is caring for a client prescribed clopidogrel. Which of the following client histories is a contraindication to the administration of this medication?

• A. Recent surgery
• B. Peptic ulcer disease
• C. Bleeding disorder
• D. Uncontrolled hypertension

Correct answer: D

Rationale: The correct answer is D: Uncontrolled hypertension. Clopidogrel should not be administered to clients with uncontrolled hypertension due to the increased risk of bleeding. Recent surgery, peptic ulcer disease, and bleeding disorders are not absolute contraindications for clopidogrel administration.

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