Nursing Elites

1. A client with a diagnosis of chronic heart failure is prescribed digoxin. What is the most important assessment before administering this medication?

• A. Check blood pressure
• B. Assess heart rate
• C. Monitor respiratory rate
• D. Measure oxygen saturation

Correct answer: B

Rationale: The correct answer is to assess the heart rate before administering digoxin. Digoxin can lead to bradycardia, making it crucial to evaluate the heart rate to prevent potential complications. Checking blood pressure (Choice A) is important but not as critical as assessing the heart rate in this context. Monitoring respiratory rate (Choice C) and measuring oxygen saturation (Choice D) are not the most crucial assessments before administering digoxin, as the primary concern with this medication is its impact on heart rate.

2. A client with a diagnosis of hypothyroidism is prescribed levothyroxine (Synthroid). Which symptom should prompt the nurse to notify the healthcare provider?

• A. Weight gain.
• B. Bradycardia.
• C. Nervousness and tremors.
• D. Fatigue.

Correct answer: C

Rationale: The correct answer is C: 'Nervousness and tremors.' In a client with hypothyroidism prescribed levothyroxine, the development of nervousness and tremors may indicate hyperthyroidism, which can result from excessive dosing of levothyroxine. Therefore, the nurse should promptly notify the healthcare provider to adjust the medication dosage. Choices A, B, and D are incorrect because weight gain, bradycardia, and fatigue are more commonly associated with hypothyroidism itself, indicating that the levothyroxine therapy may not be effective enough, rather than being signs of excessive dosing.

3. A client with chronic obstructive pulmonary disease (COPD) is using a metered-dose inhaler (MDI). What technique should the nurse emphasize?

• A. The importance of using a spacer
• B. How to synchronize breaths with inhaler activation
• C. Regular cleaning of the inhaler
• D. All of the above

Correct answer: D

Rationale: In managing COPD with a metered-dose inhaler (MDI), the nurse should emphasize all of the techniques mentioned. Using a spacer can help improve drug delivery and reduce the risk of oral thrush. Synchronizing breaths with inhaler activation ensures proper medication delivery to the lungs. Regular cleaning of the inhaler prevents blockages and ensures optimal functioning. Therefore, all these techniques are important for effective COPD management, making 'All of the above' the correct answer. Choices A, B, and C are all crucial components of proper MDI technique in COPD, so they are not individually sufficient without the others.

4. The nurse is caring for a 75-year-old male client who is beginning to form a decubitus ulcer at the coccyx. Which intervention will be most helpful in preventing further development of the decubitus ulcer?

• A. Encourage the client to eat foods high in protein
• B. Assess the client for daily range of motion exercises
• C. Teach the family how to perform sterile wound care
• D. Ensure the IV fluids are administered as prescribed

Correct answer: A

Rationale: Encouraging the client to eat foods high in protein is crucial in preventing further development of decubitus ulcers as high protein foods support tissue repair and skin integrity. Adequate protein intake is essential for wound healing. Assessing the client for daily range of motion exercises is important for preventing complications related to immobility, but it may not directly address the prevention of decubitus ulcers. Teaching the family how to perform sterile wound care is significant for wound management but may not be the most effective intervention to prevent further development of decubitus ulcers. Ensuring IV fluids are administered as prescribed is essential for maintaining hydration status but is not the most relevant intervention for preventing decubitus ulcers.

5. A client is admitted to the hospital with a diagnosis of Pneumonia. Which intervention should the nurse implement to prevent complications associated with Pneumonia?

• A. Encourage mobilization and ambulation
• B. Encourage energy conservation with complete bed rest
• C. Provide humidified oxygen via nasal cannula
• D. Restrict oral (PO) and intravenous fluids

Correct answer: A

Rationale: The correct intervention to prevent complications associated with pneumonia is to encourage mobilization and ambulation. These activities help prevent complications such as atelectasis by promoting lung expansion. Encouraging energy conservation with complete bed rest (Choice B) is not ideal as it can lead to complications like muscle weakness and decreased lung expansion. Providing humidified oxygen via nasal cannula (Choice C) is important in pneumonia treatment but does not directly prevent complications associated with pneumonia itself. Restricting oral (PO) and intravenous fluids (Choice D) is not recommended as adequate hydration is crucial for pneumonia patients to maintain respiratory function and overall health.

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