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. A client has been taking simvastatin for 3 days and calls the nurse at the clinic to report extreme muscle tenderness and pain. Which is the most appropriate action?

• A. Notify the health care provider.
• B. Review the medication with the client.
• C. Advise the client to avoid grapefruit juice.
• D. Remind the client to limit physical activity until evaluated by the health care provider.

Correct answer: A

Rationale: Extreme muscle tenderness and pain in a client taking simvastatin could indicate rhabdomyolysis, a serious condition. Promptly notifying the health care provider is crucial to evaluate and manage this potential medical emergency. Reviewing the medication with the client may not address the urgency of the situation. Advising the client to avoid grapefruit juice is not directly related to the client's current symptoms. Reminding the client to limit physical activity until evaluated by the health care provider is not appropriate as the client's symptoms should be assessed by a professional first.

3. Which assessment finding requires nursing intervention prior to the administration of medication?

• A. Apical pulse heard best at the pulmonic site
• B. Irregular apical pulse rhythm
• C. Presence of a systolic heart murmur
• D. Apical pulse rate of 50 beats/minute

Correct answer: D

Rationale: An apical pulse rate of 50 beats/minute indicates bradycardia, a heart rate below the normal range, which requires immediate nursing intervention before administering medication to address the potential impact of the bradycardia on the patient's overall condition.

4. A client with a history of stroke is prescribed clopidogrel. The nurse should monitor for which potential side effect?

• A. Bleeding
• B. Weight gain
• C. Nausea
• D. Headache

Correct answer: A

Rationale: When a client with a history of stroke is prescribed clopidogrel, the nurse should monitor for potential side effects, especially bleeding. Clopidogrel is an antiplatelet medication that works by preventing blood clots. One of the major risks associated with clopidogrel is an increased tendency to bleed. Therefore, monitoring for signs of bleeding, such as easy bruising, blood in stool or urine, or prolonged bleeding from minor cuts, is crucial to ensure patient safety and early intervention if needed.

5. A client with diabetes mellitus type 2 is prescribed linagliptin. Which instruction should the nurse include in the client's teaching plan?

• A. Report any signs of pancreatitis to the healthcare provider.
• B. Take this medication with meals.
• C. Avoid alcohol while taking this medication.
• D. Report any signs of heart failure to the healthcare provider.

Correct answer: A

Rationale: When a client is prescribed linagliptin, it is crucial to educate them to report any signs of pancreatitis to their healthcare provider. Linagliptin can lead to pancreatitis, making it essential for clients to be vigilant for symptoms such as severe abdominal pain, nausea, and vomiting. Timely reporting of these symptoms can aid in early intervention and management of pancreatitis.

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