Nursing Elites

1. A nurse is caring for a client prescribed digoxin. Which of the following should alert the nurse to possible digitalis toxicity?

• A. Anorexia and weakness
• B. Hyperactivity and hunger
• C. Tachycardia and increased urination
• D. Polyphagia and polydipsia

Correct answer: A

Rationale: The correct answer is A: Anorexia and weakness. These symptoms are early indicators of potential digitalis toxicity. Anorexia refers to a loss of appetite, which can be a sign of toxicity, and weakness can indicate an issue with digoxin. Choices B, C, and D are incorrect. Hyperactivity and hunger, tachycardia and increased urination, as well as polyphagia and polydipsia are not typically associated with digitalis toxicity.

2. A nurse is preparing to administer ondansetron to a client. Which of the following therapeutic effects should the nurse expect from this medication?

• A. Decreased nausea
• B. Increased appetite
• C. Increased heart rate
• D. Relief of headache

Correct answer: A

Rationale: The correct answer is A: Decreased nausea. Ondansetron is classified as an antiemetic medication, which means it is used to relieve nausea and vomiting by blocking serotonin in the chemoreceptor trigger zone. Therefore, the nurse administering ondansetron should expect a therapeutic effect of decreased nausea. Choice B, increased appetite, is incorrect as ondansetron does not affect appetite. Choice C, increased heart rate, is incorrect as ondansetron does not have a direct effect on heart rate. Choice D, relief of headache, is also incorrect as the primary therapeutic effect of ondansetron is to alleviate nausea and vomiting, not headaches.

3. A client is prescribed HMG CoA reductase inhibitor, atorvastatin. Which of the following should be monitored while this medication is prescribed?

• A. Liver function tests
• B. Renal function tests
• C. Visual acuity screening
• D. Hearing screenings

Correct answer: A

Rationale: The correct answer is A: Liver function tests. Atorvastatin, an HMG CoA reductase inhibitor, can lead to hepatotoxicity, making it essential to monitor liver function tests regularly. Choices B, C, and D are incorrect because atorvastatin primarily affects the liver, not the kidneys, vision, or hearing.

4. A healthcare provider is reviewing the client's history before administering opioid pain medication. Which of the following conditions is a contraindication to opioid therapy?

• A. Asthma
• B. Renal failure
• C. Diabetes mellitus
• D. Obesity

Correct answer: B

Rationale: Renal failure is a contraindication to opioid therapy due to the risk of drug accumulation and toxicity. Asthma, diabetes mellitus, and obesity are not contraindications to opioid therapy. Asthma is a respiratory condition that can be managed alongside opioids, diabetes mellitus and obesity do not directly contraindicate opioid therapy.

5. A nurse is caring for a client receiving IV vancomycin. The nurse notes flushing of the client's neck and chest. Which of the following actions should the nurse take?

• A. Stop the infusion
• B. Document the findings as a harmless reaction
• C. Slow the infusion rate
• D. Administer diphenhydramine

Correct answer: C

Rationale: The correct action for the nurse to take when a client receiving IV vancomycin shows flushing of the neck and chest is to slow the infusion rate. Flushing is a common sign of Red Man Syndrome, which is associated with rapid infusions of vancomycin. Slowing down the infusion rate can help prevent further flushing and the development of Red Man Syndrome. Stopping the infusion (Choice A) may be too drastic if the symptoms are mild and can be managed by slowing the rate. Documenting the findings as a harmless reaction (Choice B) is incorrect because flushing should be addressed promptly to prevent complications. Administering diphenhydramine (Choice D) is not the initial or best intervention for flushing associated with vancomycin; slowing the infusion rate is the priority.

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