Nursing Elites

1. A client is prescribed digoxin and has a potassium level of 3.0 mEq/L. Which of the following actions should the nurse take?

• A. Administer digoxin without any modifications
• B. Administer the medication at a lower dose
• C. Monitor serum potassium levels
• D. Discontinue the medication if potassium levels rise

Correct answer: A

Rationale: A potassium level of 3.0 mEq/L indicates hypokalemia, which increases the risk of digoxin toxicity. In this case, the nurse should administer the digoxin without any modifications. Lowering the dose (Choice B) may not be necessary if the potassium level is not critically low. Monitoring serum potassium levels (Choice C) is important but should not delay the administration of digoxin. Discontinuing the medication (Choice D) is not the initial action to take unless the potassium levels become severely low and life-threatening.

2. A nurse is caring for a client who has been prescribed methadone. Which of the following client statements indicates a need for further teaching?

• A. I understand methadone slows my breathing.
• B. I understand methadone may cause me to have trouble sleeping.
• C. I will avoid alcohol while I’m taking this medication.
• D. I’ll change positions slowly, especially when standing.

Correct answer: B

Rationale: The correct answer is B because methadone typically causes sedation and respiratory depression, not trouble sleeping. The statement about trouble sleeping indicates a need for further teaching. Choices A, C, and D are incorrect because understanding that methadone slows breathing, avoiding alcohol while taking the medication, and changing positions slowly to prevent dizziness are all appropriate client statements when prescribed methadone.

3. A nurse is providing teaching to a client who has mild persistent asthma and has been prescribed montelukast. Which of the following statements should the nurse include in the teaching?

• A. This medication can be used to help manage asthma symptoms during an acute asthma attack
• B. This medication should be taken before exercise and physical activity
• C. This medication should be taken regularly as prescribed without discontinuing abruptly
• D. This medication helps decrease swelling and mucus production

Correct answer: D

Rationale: Montelukast works as a leukotriene receptor antagonist, reducing inflammation and mucus production, which helps prevent asthma attacks but is not used for acute treatment. It is important for the client to understand that montelukast should be taken regularly to manage asthma symptoms and should not be abruptly discontinued. Taking the medication before exercise is not a typical instruction for montelukast.

4. A nurse is assessing a client 1 hour after birth and notes a boggy uterus located 2 cm above the umbilicus. What should the nurse do first?

• A. Take vital signs
• B. Assess lochia
• C. Massage the fundus
• D. Give oxytocin IV bolus

Correct answer: C

Rationale: A boggy uterus located 2 cm above the umbilicus suggests uterine atony, which is a common cause of postpartum hemorrhage. The initial intervention in this situation is to massage the fundus. Fundal massage helps the uterus contract, promoting hemostasis and preventing excessive bleeding. Taking vital signs or assessing lochia are important actions but are secondary to addressing uterine atony. Administering oxytocin IV bolus is often done after fundal massage to further enhance uterine contractions.

5. A nurse is preparing a client for a colonoscopy. Which of the following medications should the nurse anticipate the provider to prescribe as an anesthetic for the procedure?

• A. Propofol
• B. Pancuronium
• C. Promethazine
• D. Pentoxifylline

Correct answer: A

Rationale: The correct answer is A, Propofol. Propofol is a short-acting anesthetic medication commonly used to induce moderate sedation for procedures like a colonoscopy. This medication provides rapid onset and recovery, making it an ideal choice for such procedures. Choice B, Pancuronium, is a neuromuscular blocking agent used for muscle relaxation during surgery and would not be appropriate for sedation during a colonoscopy. Choice C, Promethazine, is an antihistamine used for nausea and motion sickness, not for anesthesia. Choice D, Pentoxifylline, is a medication used to improve blood flow in patients with circulation problems and is not indicated for anesthesia during a colonoscopy.

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