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 45-year-old client is taking methylprednisolone. What pharmacologic action should the nurse expect with this therapy?

• A. Suppression of beta2 receptors
• B. Suppression of airway mucus production
• C. Fortification of bones
• D. Suppression of candidiasis

Correct answer: B

Rationale: The correct answer is B: Suppression of airway mucus production. Corticosteroids like methylprednisolone are known to suppress airway mucus production. This action helps in reducing inflammation and swelling in the airways, making breathing easier for individuals with conditions like asthma or COPD. Choices A, C, and D are incorrect. Suppression of beta2 receptors is more related to beta-blockers, fortification of bones is associated with medications like bisphosphonates, and suppression of candidiasis is not a typical pharmacologic action of methylprednisolone.

3. A nurse is preparing to administer an intramuscular injection to an adult client. At what angle should the nurse administer the medication using the ventrogluteal site?

• A. a 45-degree angle
• B. a 60-degree angle
• C. a 75-degree angle
• D. a 90-degree angle

Correct answer: D

Rationale: Intramuscular injections in the ventrogluteal site should be administered at a 90-degree angle. This angle ensures that the medication reaches the muscle tissue effectively. Angles less than 90 degrees can cause subcutaneous injection instead of intramuscular, leading to slower absorption of the medication. Angles greater than 90 degrees risk hitting bone or nerves, causing unnecessary pain or injury. Therefore, the correct angle for administering intramuscular injections in the ventrogluteal site is 90 degrees.

4. A healthcare provider is preparing to administer heparin sodium to a client with deep vein thrombosis (DVT). Which of the following laboratory values should the provider monitor during therapy?

• A. INR
• B. Serum creatinine
• C. aPTT
• D. Bilirubin

Correct answer: C

Rationale: The correct answer is C: aPTT. The healthcare provider should monitor the activated partial thromboplastin time (aPTT) value during heparin therapy to assess the client's coagulation status. Heparin affects the intrinsic pathway of the coagulation cascade, and monitoring aPTT helps ensure that the client is within the therapeutic range to prevent bleeding or clotting issues. INR (Choice A) is used to monitor warfarin therapy, not heparin. Serum creatinine (Choice B) is not directly related to monitoring heparin therapy. Bilirubin (Choice D) is related to liver function, not heparin therapy.

5. A client receiving epoetin alfa therapy for anemia is being monitored for therapeutic effects. Which of the following laboratory values indicates the medication is effective?

• A. White blood cell count
• B. Hematocrit
• C. Platelet count
• D. Red blood cell count

Correct answer: B

Rationale: The correct answer is B: Hematocrit. An increase in hematocrit levels indicates the effectiveness of epoetin alfa in treating anemia. Hematocrit reflects the percentage of red blood cells in the blood, so an increase in hematocrit signifies an improvement in the patient's red blood cell count and oxygen-carrying capacity. Choices A, C, and D are incorrect because white blood cell count, platelet count, and red blood cell count do not directly reflect the therapeutic effects of epoetin alfa in treating anemia.

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