Nursing Elites

1. A client with heart failure is receiving digoxin. Which finding should indicate to the nurse that the client is experiencing digoxin toxicity?

• A. Constipation
• B. Blurred vision
• C. Bradycardia
• D. Dry cough

Correct answer: C

Rationale: Bradycardia is a hallmark sign of digoxin toxicity. Digoxin, a medication used to treat heart conditions, can lead to toxicity manifesting as bradycardia. Bradycardia occurs due to the drug's effect on slowing down the heart rate excessively. Constipation (Choice A) is not typically associated with digoxin toxicity. Blurred vision (Choice B) is more commonly linked to visual disturbances caused by digoxin, but it is not a defining sign of toxicity. Dry cough (Choice D) is not a recognized symptom of digoxin toxicity. It is crucial for the nurse to recognize the early signs of digoxin toxicity to prevent serious complications and provide appropriate interventions promptly.

2. A healthcare provider is providing discharge instructions to a client who has a new prescription for warfarin. Which of the following statements should the healthcare provider include?

• A. Avoid using a soft toothbrush.
• B. Report any signs of bleeding.
• C. Increase your intake of leafy green vegetables.
• D. Take the medication with food.

Correct answer: B

Rationale: The correct answer is to instruct the client to report any signs of bleeding when taking warfarin. Warfarin is an anticoagulant medication that increases the risk of bleeding, so it is essential to monitor for any signs of abnormal bleeding and report them promptly for appropriate management. Choices A, C, and D are incorrect. Instructing the client to avoid using a soft toothbrush is not directly related to warfarin therapy. Increasing the intake of leafy green vegetables is not recommended as they contain vitamin K, which can interfere with warfarin's anticoagulant effects. Taking warfarin with food can be inconsistent and may not result in optimal absorption.

3. The nurse is caring for a client with coronary artery disease (CAD) who reports chest pain. The nurse administers nitroglycerin as prescribed. What is the next priority action?

• A. Obtain a 12-lead ECG
• B. Monitor the client's blood pressure
• C. Notify the healthcare provider
• D. Administer a second dose of nitroglycerin

Correct answer: B

Rationale: After administering nitroglycerin, the next priority action is to monitor the client's blood pressure. Nitroglycerin can cause vasodilation and subsequent hypotension, so it is crucial to assess the client's blood pressure to prevent complications and ensure safety. Obtaining a 12-lead ECG may be necessary but monitoring blood pressure takes precedence to detect and manage potential hypotension. Notifying the healthcare provider can be done after ensuring the client's stability. Administering a second dose of nitroglycerin without assessing the client's response and blood pressure can lead to further hypotension.

4. A client diagnosed with angina pectoris returns to the nursing unit after experiencing an angioplasty. The nurse reinforces instructions to the client regarding the procedure and home care measures. Which statement by the client indicates an understanding of the instructions?

• A. I am considering cutting my workload.
• B. I need to cut down on cigarette smoking.
• C. I am so relieved that my heart is repaired.
• D. I need to adhere to my dietary restrictions.

Correct answer: B

Rationale: The correct answer is B because cutting down on cigarette smoking is crucial for improving heart health after angioplasty. Smoking cessation helps in reducing the risk of complications and promotes better outcomes. Choices A and C are not directly related to post-angioplasty care. While reducing workload may be beneficial, it is not specifically related to the client's cardiac health. Feeling relieved that the heart is repaired is a positive emotional response but does not reflect understanding of the necessary measures. Adhering to dietary restrictions is important, but in this scenario, smoking cessation takes higher priority due to its immediate impact on heart health.

5. When reinforcing dietary instructions to a client with coronary artery disease prescribed a low-fat, low-cholesterol diet, which food item should the nurse advise the client to choose?

• A. Whole milk
• B. Grilled salmon
• C. Fried chicken
• D. Bacon and eggs

Correct answer: B

Rationale: Grilled salmon is the correct choice for a client with coronary artery disease on a low-fat, low-cholesterol diet because it is low in saturated fat and high in omega-3 fatty acids, which are beneficial for heart health. Whole milk, fried chicken, and bacon and eggs are higher in saturated fats and cholesterol, making them less suitable choices for this client. Whole milk is high in saturated fat, while fried chicken and bacon and eggs are sources of both saturated fat and cholesterol, which can negatively impact heart health in clients with coronary artery disease.

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