Nursing Elites

1. A client with a history of congestive heart failure (CHF) is receiving digoxin (Lanoxin). The nurse should monitor the client for which sign of digoxin toxicity?

• A. Hypertension
• B. Bradycardia
• C. Hyperglycemia
• D. Insomnia

Correct answer: B

Rationale: Bradycardia is a common sign of digoxin toxicity. Digoxin can cause bradycardia due to its effects on the heart's electrical conduction system. The nurse should closely monitor the client's heart rate for any signs of slowing down, as it can indicate toxicity and potentially lead to serious complications. Hypertension, hyperglycemia, and insomnia are not typically associated with digoxin toxicity. Hypertension is more commonly associated with other conditions or medications, hyperglycemia can be seen in conditions like diabetes or certain medications, and insomnia is not a typical sign of digoxin toxicity.

2. The nurse is preparing to care for a client who will be arriving from the recovery room after an above-the-knee amputation. The nurse ensures that which priority item is available for emergency use?

• A. Surgical tourniquet
• B. Dry sterile dressings
• C. Incentive spirometer
• D. Over-the-bed trapeze

Correct answer: A

Rationale: In the case of an above-the-knee amputation, the priority item that should be available for emergency use is a surgical tourniquet. This is crucial to control severe bleeding that may occur post-operatively. Dry sterile dressings (choice B) are important for wound care but not for immediate post-operative emergencies like bleeding. An incentive spirometer (choice C) is used for respiratory exercises and not directly related to emergency management post-amputation. An over-the-bed trapeze (choice D) is used for assisting clients with mobility and positioning, not for emergency situations involving bleeding.

3. A hypertensive client who has been taking metoprolol (Lopressor) has been prescribed to decrease the dose of the medication. The client asks the nurse why this must be done over a period of 1 to 2 weeks. In formulating a response, the nurse incorporates the understanding that abrupt withdrawal could affect the client in which way?

• A. Result in hypoglycemia
• B. Give the client insomnia
• C. Precipitate rebound hypertension
• D. Cause enhanced side effects of other prescribed medications

Correct answer: C

Rationale: Abruptly stopping metoprolol can lead to rebound hypertension, causing a sudden increase in blood pressure due to the sudden withdrawal of the medication. Gradually tapering the dose helps the body adjust and reduces the risk of this adverse effect. Choices A, B, and D are incorrect. Stopping metoprolol suddenly is not known to result in hypoglycemia, insomnia, or enhanced side effects of other medications.

4. A healthcare professional is assessing a client who has been taking isoniazid to treat tuberculosis. The healthcare professional should monitor the client for which of the following findings as an adverse effect of the medication?

• A. Diarrhea
• B. Blurred vision
• C. Hearing loss
• D. Jaundice

Correct answer: D

Rationale: Correct. Jaundice is a serious adverse effect of isoniazid due to liver damage. It is essential to monitor for signs of liver toxicity, such as jaundice, while the client is on this medication. Diarrhea is a common side effect of isoniazid, but it is not as serious as liver damage. Blurred vision and hearing loss are not typically associated with isoniazid use.

5. The healthcare provider is monitoring a client with left-sided heart failure. Which assessment finding indicates that the client's condition is worsening?

• A. Clear lung sounds
• B. Increased peripheral pulses
• C. Bibasilar crackles
• D. Improved activity tolerance

Correct answer: C

Rationale: Bibasilar crackles are abnormal lung sounds that indicate fluid accumulation in the lungs, a sign that left-sided heart failure is worsening. This finding suggests that the client's condition is deteriorating and requires prompt intervention to prevent further complications. Clear lung sounds (Choice A) are normal and would not indicate worsening heart failure. Increased peripheral pulses (Choice B) may be seen in conditions like anxiety or exercise, but not specifically in worsening left-sided heart failure. Improved activity tolerance (Choice D) would be a positive sign, not an indicator of worsening heart failure.

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