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 nurse is preparing to administer ondansetron to a client. Which of the following therapeutic effects should the nurse expect from this medication?

• A. Decreased nausea
• B. Increased appetite
• C. Increased heart rate
• D. Relief of headache

Correct answer: A

Rationale: The correct answer is A: Decreased nausea. Ondansetron is classified as an antiemetic medication, which means it is used to relieve nausea and vomiting by blocking serotonin in the chemoreceptor trigger zone. Therefore, the nurse administering ondansetron should expect a therapeutic effect of decreased nausea. Choice B, increased appetite, is incorrect as ondansetron does not affect appetite. Choice C, increased heart rate, is incorrect as ondansetron does not have a direct effect on heart rate. Choice D, relief of headache, is also incorrect as the primary therapeutic effect of ondansetron is to alleviate nausea and vomiting, not headaches.

3. A nurse has provided education to a client regarding prescribed levothyroxine sodium. Which of the following client statements demonstrates understanding of medication administration?

• A. I should take my medication as needed to alleviate symptoms
• B. I should take the medication in divided doses to ensure therapeutic drug levels
• C. I should take the medication in the morning to prevent insomnia
• D. I should take the medication on a full stomach

Correct answer: C

Rationale: Levothyroxine should be taken once in the morning to prevent insomnia and maintain therapeutic levels.

4. A nurse is preparing to administer nitroglycerin ointment to a client. Which of the following actions should the nurse take?

• A. Apply the ointment to the client's hairless chest
• B. Rub the ointment gently into the skin
• C. Cover the applied ointment with a transparent dressing
• D. Massage the ointment into the skin

Correct answer: A

Rationale: The correct action is to apply the nitroglycerin ointment to a hairless area of the client's chest, back, or upper arms. This allows for better absorption of the medication. Choice B is incorrect because rubbing the ointment gently into the skin may be appropriate, but the primary action is to ensure application on a hairless area. Choice C is incorrect as covering the ointment with a transparent dressing is not a standard practice for nitroglycerin ointment administration. Choice D is incorrect because massaging the ointment into the skin is not recommended, as it can alter absorption rates.

5. A client is receiving magnesium sulfate for the management of preeclampsia. Which of the following client assessments should the nurse monitor to prevent complications of therapy?

• A. Bowel sounds
• B. Deep tendon reflexes
• C. Oxygen saturation
• D. Fluid balance

Correct answer: B

Rationale: The correct answer is deep tendon reflexes. Monitoring deep tendon reflexes is crucial to assess for magnesium toxicity during therapy for preeclampsia. Magnesium sulfate can lead to neuromuscular blockade, reflected by decreased or absent deep tendon reflexes. Assessing bowel sounds (choice A) is important for gastrointestinal function but is not directly related to magnesium sulfate therapy. Oxygen saturation (choice C) is vital for respiratory status but is not specifically linked to magnesium sulfate administration. Fluid balance (choice D) is essential but does not directly correlate with monitoring for complications of magnesium sulfate therapy in the context of preeclampsia.

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