Nursing Elites

1. A client is receiving digoxin therapy. Which of the following should the nurse monitor?

• A. Liver function
• B. Serum electrolytes
• C. Blood pressure
• D. All of the above

Correct answer: D

Rationale: When a client is receiving digoxin therapy, it is crucial for the nurse to monitor liver function, serum electrolytes (especially potassium levels), and blood pressure. Digoxin is known to affect the heart's electrical activity and can lead to toxic effects if not managed properly. Monitoring liver function helps to assess the drug's metabolism and excretion. Checking serum electrolytes, especially potassium, is essential because digoxin toxicity can be exacerbated by electrolyte imbalances, particularly hypokalemia. Monitoring blood pressure is necessary because digoxin can influence cardiac contractility and heart rate, potentially affecting blood pressure. Therefore, monitoring all these parameters is vital to ensure the client's safety and therapeutic effectiveness of digoxin. Choices A, B, and C are incorrect because monitoring only one or two of these parameters may not provide a comprehensive assessment of the client's response to digoxin therapy.

2. A client is to undergo a liver biopsy. Which of the following instructions should the nurse provide to the client following the procedure?

• A. “Lie on your left side.”
• B. “Lie on your right side.”
• C. “Increase your fluid intake.”
• D. “Decrease your fluid intake.”

Correct answer: B

Rationale: Following a liver biopsy, the nurse should instruct the client to lie on the right side to promote hemostasis. This position helps apply pressure to the biopsy site, reducing the risk of bleeding. Instructing the client to lie on the left side (Choice A) would not provide the same benefit. Increasing fluid intake (Choice C) is generally beneficial post-procedure to prevent dehydration and promote healing. Decreasing fluid intake (Choice D) is not advisable as it can lead to dehydration and potential complications.

3. A nurse is assessing a 1-hour postpartum client and notes a boggy uterus located 2 cm above the umbilicus. Which of the following actions should the nurse take first?

• A. Take vital signs
• B. Assess lochia
• C. Massage the fundus
• D. Give oxytocin IV bolus

Correct answer: C

Rationale: When a nurse assesses a 1-hour postpartum client with a boggy uterus located 2 cm above the umbilicus, it indicates uterine atony. The first action the nurse should take is to massage the fundus. Fundal massage helps stimulate uterine contractions, which will reduce bleeding and prevent postpartum hemorrhage. Taking vital signs, assessing lochia, or administering an oxytocin IV bolus are important interventions but should come after addressing uterine atony through fundal massage.

4. A client with heart failure and a new prescription for furosemide is receiving teaching from a nurse. Which of the following instructions should the nurse include?

• A. Avoid foods high in magnesium
• B. Take furosemide with food
• C. Eat foods that are rich in potassium
• D. Expect a decrease in blood pressure

Correct answer: C

Rationale: The correct instruction the nurse should include is to advise the client to eat foods that are rich in potassium. Furosemide is a loop diuretic that can cause the loss of potassium, leading to hypokalemia. Eating foods high in potassium can help prevent this electrolyte imbalance. Choice A is incorrect because furosemide does not directly interact with magnesium. Choice B is incorrect because furosemide is usually taken in the morning to prevent nighttime diuresis. Choice D is incorrect because furosemide is a diuretic that typically leads to a decrease in blood pressure rather than an increase.

5. A healthcare provider is discussing recommendations for daily nutrient intake during pregnancy with a client who is at 10 weeks of gestation. For which of the following nutrients should the healthcare provider instruct the client to increase intake during pregnancy?

• A. Vitamin E
• B. Vitamin D
• C. Fiber
• D. Calcium

Correct answer: D

Rationale: The correct answer is D: Calcium. During pregnancy, it is essential to increase calcium intake as it is crucial for fetal bone development and to prevent maternal bone loss. Adequate calcium supports the increased needs of both the mother and the developing baby. Vitamin E, Vitamin D, and fiber are also important nutrients, but the specific nutrient that needs to be increased during pregnancy for bone development is calcium. Vitamin E is an antioxidant that plays a role in protecting cells from damage, Vitamin D helps with calcium absorption and bone health, and fiber is important for digestive health but does not specifically need to be increased during pregnancy for bone development.

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