Nursing Elites

1. A client with chronic obstructive pulmonary disease (COPD) is prescribed theophylline. Which adverse effect should the nurse monitor for that indicates toxicity?

• A. Tachycardia
• B. Constipation
• C. Drowsiness
• D. Tremors

Correct answer: A

Rationale: The correct answer is A: Tachycardia. Tachycardia is a common sign of theophylline toxicity. The nurse should monitor the client for an increased heart rate, as it can indicate a dangerous level of theophylline in the body. Prompt medical attention is required if tachycardia is observed to prevent further complications. Choices B, C, and D are incorrect because constipation, drowsiness, and tremors are not typically associated with theophylline toxicity. While theophylline can cause gastrointestinal upset or central nervous system effects, tachycardia is a more specific and serious indicator of toxicity that requires immediate attention.

2. The client has been prescribed warfarin (Coumadin) and is being educated about dietary restrictions. Which food should the client be advised to avoid or eat in consistent amounts?

• A. Bananas
• B. Spinach
• C. Oranges
• D. Yogurt

Correct answer: B

Rationale: Spinach is high in vitamin K, which can interfere with the effectiveness of warfarin. It is important for clients taking warfarin to maintain consistent levels of vitamin K intake to ensure the medication works properly. Foods rich in vitamin K, such as spinach, can counteract the effects of warfarin, leading to potential complications. Therefore, clients on warfarin are advised to either avoid or consume vitamin K-rich foods, like spinach, in consistent amounts to maintain the medication's efficacy. Bananas, oranges, and yogurt are not high in vitamin K and do not significantly impact the effectiveness of warfarin, making them safe options for clients taking this medication.

3. A client with a history of angina pectoris reports chest pain after climbing stairs. What should be the nurse's first action?

• A. Administer oxygen.
• B. Administer nitroglycerin.
• C. Sit the client down and rest.
• D. Check the client's blood pressure.

Correct answer: C

Rationale: The correct action for a client experiencing anginal pain, like chest pain after climbing stairs, is to sit the client down and have them rest. Resting reduces myocardial oxygen demand, which can help relieve anginal pain. Administering oxygen or nitroglycerin may be appropriate interventions after the client has been seated and rested. Checking the client's blood pressure is important but not the immediate priority when a client is experiencing anginal pain. Therefore, the first action should be to sit the client down and allow them to rest.

4. A healthcare professional is assessing a client who is taking digoxin. Which of the following findings should the healthcare professional report to the provider?

• A. Weight gain
• B. Dry cough
• C. Hypokalemia
• D. Bradycardia

Correct answer: D

Rationale: Bradycardia is a significant finding in a client taking digoxin as it is a sign of digoxin toxicity. Bradycardia can indicate that the client is experiencing an adverse reaction to the medication, potentially leading to serious complications. Therefore, it is crucial for the healthcare professional to report bradycardia to the provider promptly for further evaluation and intervention. Weight gain, dry cough, and hypokalemia are not typically associated with digoxin toxicity and may have other underlying causes. While weight gain and cough can be monitored, bradycardia requires immediate attention due to its potential link to digoxin toxicity.

5. A client has a new prescription for isoniazid. Which of the following instructions should the nurse include?

• A. Take the medication on an empty stomach.
• B. Avoid drinking alcohol.
• C. Take the medication with an antacid.
• D. Increase your intake of leafy green vegetables.

Correct answer: B

Rationale: The correct answer is to instruct the client to avoid drinking alcohol. Isoniazid can cause liver damage, and alcohol consumption can increase this risk. Therefore, it is crucial to avoid alcohol while taking isoniazid to prevent potential liver complications. Choice A is incorrect because isoniazid is typically taken with food to reduce gastrointestinal upset. Choice C is incorrect because antacids can decrease the absorption of isoniazid. Choice D is incorrect as there is no specific recommendation to increase leafy green vegetable intake when taking isoniazid.

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