Nursing Elites

1. A client with a history of atrial fibrillation is prescribed digoxin. The nurse should monitor for which potential side effect?

• A. Bradycardia
• B. Tachycardia
• C. Headache
• D. Hyperglycemia

Correct answer: A

Rationale: The correct answer is A: Bradycardia. Digoxin can lead to bradycardia due to its effect on slowing down the heart rate, which can be dangerous in a client with atrial fibrillation. Monitoring the client's heart rate is essential to detect and manage this potential side effect. Choices B, C, and D are incorrect because digoxin is not known to cause tachycardia, headache, or hyperglycemia as common side effects.

2. In the emergency department, a child is admitted for accidental ingestion of a poison. The practical nurse (PN) should know that inducing vomiting is recommended for which child?

• A. An 8-month-old who ingested four to six ibuprofen tablets
• B. A 3-year-old who drank an unknown amount of charcoal lighter fluid
• C. A 16-month-old who ingested 2 ounces of acetaminophen elixir
• D. A 2-year-old who ate a handful of automatic dishwasher detergent

Correct answer: C

Rationale: Inducing emesis is recommended for the child who ingested a large dose of acetaminophen elixir because this medication is hepatotoxic. Acetaminophen overdose can lead to severe liver damage, and prompt removal from the stomach can help reduce absorption and potential harm.

3. What information should the practical nurse provide to a female client who started taking an oral sulfonamide for a urinary tract infection the previous day and reports slight anorexia, while also experiencing urinary frequency?

• A. Take the medication with an antacid instead of cranberry juice to reduce the anorexia.
• B. Continue to take the medication with a sip of cranberry juice, restricting fluids until the frequency is controlled.
• C. Continue to drink cranberry juice, but take the medicine on an empty stomach with a full glass of water.
• D. Take the medication with a spoonful of ice cream or applesauce and avoid drinking cranberry juice.

Correct answer: C

Rationale: The practical nurse should advise the client to take sulfonamides with a full glass of water to help prevent crystalluria. It is essential to take the medication on an empty stomach, ideally 1 hour before eating or 2 hours after eating to maximize its absorption and effectiveness. Continuing to drink cranberry juice is beneficial, but it is important to take the medicine separately to enhance its therapeutic action.

4. The healthcare provider is discharging a patient with a new prescription for ranitidine (Zantac). Which information would be important to include in the discharge teaching?

• A. Thrombolytic thrombocytopenic purpura (TTP) may occur
• B. Aspirin should not be taken with this medication
• C. The patient may experience iron deficiency anemia
• D. The patient may experience restlessness

Correct answer: D

Rationale: The correct answer is D. It is important to include information that ranitidine may cause restlessness as a side effect in some patients. Educating the patient about possible side effects helps in early recognition and management, improving medication adherence and patient safety. Choices A, B, and C are incorrect because they do not pertain to common side effects or specific considerations related to ranitidine use.

5. A client is prescribed ondansetron for nausea and vomiting. The nurse should monitor the client for which potential adverse effect?

• A. Headache
• B. Diarrhea
• C. Constipation
• D. Increased appetite

Correct answer: C

Rationale: The correct answer is C: Constipation. Ondansetron is known to cause constipation as a potential adverse effect. It is important for the nurse to monitor the client for constipation while on this medication to address any issues promptly. Choices A, B, and D are incorrect because headache, diarrhea, and increased appetite are not common adverse effects associated with ondansetron.

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