Nursing Elites

1. A healthcare professional in a provider's office is monitoring serum electrolytes for four older adult clients who take digoxin. Which of the following electrolyte values increases a client's risk for Digoxin toxicity?

• A. Calcium 9.2 mg/dL
• B. Calcium 10.3 mg/dL
• C. Potassium 3.4 mEq/L
• D. Potassium 4.8 mEq/L

Correct answer: C

Rationale: The correct answer is C: Potassium 3.4 mEq/L. Potassium 3.4 mEq/L is below the expected reference range and puts a client at risk for digoxin toxicity. Low potassium levels can lead to fatal dysrhythmias, especially in older clients taking Digoxin, as potassium plays a crucial role in the heart's electrical activity. Choices A and B are related to calcium levels, which do not directly increase the risk of Digoxin toxicity. Choice D, Potassium 4.8 mEq/L, is within the expected reference range and would not increase the risk of Digoxin toxicity.

2. A healthcare professional is preparing to administer an IV bolus of Morphine to a client for pain management. Which of the following assessments is the healthcare professional's priority?

• A. Respiratory rate
• B. Pain level
• C. Blood pressure
• D. Level of consciousness

Correct answer: A

Rationale: The priority assessment for a client receiving an IV bolus of Morphine is the respiratory rate. Morphine can cause respiratory depression, which is a serious adverse effect. Monitoring the respiratory rate is crucial to detect any signs of respiratory compromise early and intervene promptly. Assessing pain level, blood pressure, and level of consciousness are also important but not the priority in this situation. Pain level can be assessed after ensuring the client's respiratory status is stable. Blood pressure and level of consciousness should be monitored but do not take precedence over the respiratory rate when administering Morphine.

3. When reviewing a client's health record, a nurse notes a new prescription for Lisinopril 10 mg PO once daily. The nurse should identify this as which type of prescription?

• A. Single
• B. Stat
• C. Routine
• D. Standing

Correct answer: C

Rationale: A routine prescription indicates medications to be administered on a regular schedule without a termination date or a specific number of doses. In this case, Lisinopril 10 mg PO once daily falls under a routine prescription, meaning the nurse will administer this medication daily until the provider discontinues it. Choices A, B, and D are incorrect: A 'single' prescription is for a one-time dose, 'stat' prescriptions are for immediate administration, and 'standing' prescriptions are pre-authorized for administration as needed within specified parameters.

4. A client has ordered a thrombolytic medication for the treatment of CVA. Which type of stroke should not be treated with a thrombolytic?

• A. Hemorrhagic stroke
• B. Thrombotic stroke
• C. Both types can be treated with a thrombolytic
• D. Neither type can be treated with a thrombolytic

Correct answer: A

Rationale: Thrombolytic medications are used to dissolve blood clots. In the case of a hemorrhagic stroke, where there is bleeding in the brain, the use of thrombolytics can worsen the condition by increasing bleeding. Therefore, hemorrhagic strokes should not be treated with thrombolytic medications.

5. Which of the following is not an effect of the drug isoflurane?

• A. Elevated lipid levels
• B. Nausea
• C. Increased blood flow to the brain
• D. Decreased respiratory function

Correct answer: A

Rationale: Isoflurane is not known to cause elevated lipid levels. Common effects of isoflurane include nausea, increased blood flow to the brain, and decreased respiratory function. Elevated lipid levels are not typically associated with the administration of isoflurane, making choice A the correct answer.

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