Nursing Elites

1. During an assessment, a client taking valproic acid exhibits elevated liver enzymes. What finding should the nurse report to the provider?

• A. Elevated liver enzymes
• B. Weight loss
• C. Dry mouth
• D. Increased appetite

Correct answer: A

Rationale: Elevated liver enzymes are a critical finding that the nurse should report to the provider when assessing a client taking valproic acid. It can be indicative of hepatotoxicity, a severe side effect associated with valproic acid use. Timely reporting and intervention are essential to prevent further complications and ensure the client's safety and well-being. Choices B, C, and D are not directly related to valproic acid use or the manifestation of hepatotoxicity. Weight loss, dry mouth, and increased appetite are not typically associated with elevated liver enzymes in the context of valproic acid administration.

2. The nurse is caring for a client who has undergone a coronary artery bypass graft (CABG) surgery. Which action should the nurse take to prevent postoperative complications?

• A. Encourage the client to cough and deep breathe every 1 to 2 hours.
• B. Maintain the client in a supine position at all times.
• C. Keep the client on bed rest for the first 48 hours.
• D. Restrict the client's fluid intake to prevent overload.

Correct answer: A

Rationale: Encouraging the client to cough and deep breathe every 1 to 2 hours is crucial post-CABG surgery to prevent respiratory complications, such as atelectasis and pneumonia. These actions help to expand lung volume, clear secretions, and prevent the collapse of alveoli. Choices B, C, and D are incorrect because maintaining the client in a supine position at all times can lead to complications like decreased lung expansion, keeping the client on bed rest for the first 48 hours may increase the risk of thromboembolism, and restricting fluid intake postoperatively can lead to dehydration and electrolyte imbalances.

3. A client with heart failure is being discharged with a prescription for digoxin (Lanoxin). The nurse should include which instruction in the discharge teaching?

• A. Take your pulse before each dose and hold the medication if your pulse is below 60 beats per minute
• B. Increase your fluid intake to at least 3 liters per day
• C. Report any weight loss of more than 2 pounds in a week
• D. Take the medication with meals to avoid gastrointestinal upset

Correct answer: A

Rationale: The correct instruction for a client taking digoxin is to monitor the pulse before each dose and hold the medication if the pulse is below 60 beats per minute. Digoxin can cause bradycardia, so it is crucial to assess the pulse rate before administration to prevent potential complications. Choices B, C, and D are incorrect because increasing fluid intake, reporting weight loss, or taking the medication with meals are not specific instructions related to the safe use of digoxin.

4. Prior to a dipyridamole thallium scan, what substance should the LPN/LVN ensure the client has not consumed?

• A. Caffeine
• B. Fatty meal
• C. Excess sugar
• D. Milk products

Correct answer: A

Rationale: Caffeine should be avoided before a dipyridamole thallium scan as it can interfere with the test results. Caffeine is a stimulant that can affect the heart rate and may lead to inaccurate findings during the scan. Fatty meals, excess sugar, and milk products do not specifically interfere with the dipyridamole thallium scan procedure. Therefore, it is essential for the LPN/LVN to check and ensure that the client has not consumed caffeine prior to the procedure to obtain accurate diagnostic results.

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

• A. Use the inhaler every 4 hours around the clock.
• B. Shake the inhaler well before use.
• C. Rinse your mouth with water after each use.
• D. Use the inhaler while lying down.

Correct answer: B

Rationale: Shaking the inhaler well before use is crucial as it helps ensure proper mixing of the medication, which is essential for effective delivery of the drug to the lungs. This step is important for optimal therapeutic effects of albuterol inhalation. Choices A, C, and D are incorrect. Using the inhaler every 4 hours around the clock without specifying a maximum number of doses can lead to overuse. Rinsing the mouth with water after each use is typically advised for inhaled corticosteroids to reduce the risk of oral thrush, not for albuterol. Using the inhaler while lying down is not recommended as it may lead to improper medication delivery to the lungs.

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