Nursing Elites

1. A client has a new prescription for Digoxin to treat heart failure. Which of the following findings should the nurse monitor as an adverse effect?

• A. Visual disturbances
• B. Dry cough
• C. Confusion
• D. Urinary retention

Correct answer: A

Rationale: Visual disturbances, such as blurred or yellow vision, can be an early sign of digoxin toxicity. Monitoring for visual changes is crucial to detect and prevent potential adverse effects of digoxin. Dry cough, confusion, and urinary retention are not commonly associated adverse effects of digoxin and are not typically monitored in relation to this medication.

2. A healthcare professional is preparing to administer vancomycin to a client. The professional should monitor for which of the following adverse effects?

• A. Nephrotoxicity
• B. Hepatotoxicity
• C. Red Man Syndrome
• D. Diarrhea

Correct answer: C

Rationale: Red Man Syndrome is a common adverse effect of vancomycin characterized by flushing and rash. It is not related to nephrotoxicity, hepatotoxicity, or diarrhea. Monitoring for this reaction allows for prompt intervention to prevent severe complications.

3. What is the antidote for Heparin?

• A. Protamine sulfate
• B. Narcan
• C. Romazicon
• D. Naloxone

Correct answer: A

Rationale: The correct answer is A: Protamine sulfate. Heparin is an anticoagulant medication used to prevent blood clots. In cases of overdose or excessive bleeding due to Heparin, protamine sulfate is administered as the specific antidote. Protamine sulfate works by neutralizing Heparin's anticoagulant activity. Choices B, C, and D are incorrect. Narcan (Naloxone) is used to reverse opioid overdose, Romazicon (Flumazenil) is used to reverse benzodiazepine overdose, and Naloxone is also used to reverse opioid overdose but is not the antidote for Heparin.

4. A healthcare provider is providing discharge instructions to a client who has a new prescription for Warfarin. Which of the following over-the-counter medications should the provider instruct the client to avoid?

• A. Acetaminophen
• B. Ibuprofen
• C. Diphenhydramine
• D. Loratadine

Correct answer: B

Rationale: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can increase the risk of bleeding when taken with Warfarin due to its antiplatelet effects. The combination of Warfarin, an anticoagulant, and NSAIDs can potentiate the risk of bleeding complications. Clients on Warfarin should avoid NSAIDs like ibuprofen and opt for alternative pain relief options such as acetaminophen. Diphenhydramine and loratadine are antihistamines and are generally safe to use with Warfarin as they do not significantly increase the risk of bleeding when compared to NSAIDs like ibuprofen.

5. A client with peptic ulcer disease is prescribed sucralfate. Which of the following instructions should the nurse include?

• A. Take sucralfate with meals.
• B. Take sucralfate 1 hr before meals.
• C. Take sucralfate with antacids.
• D. Take sucralfate 2 hours after meals.

Correct answer: B

Rationale: The correct instruction for taking sucralfate is 1 hour before meals. This timing allows sucralfate to effectively coat the stomach lining and provide a protective barrier against gastric acid, helping to prevent ulcers.

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