Nursing Elites

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

• A. Increase your intake of bran fiber.
• B. Monitor your heart rate before taking the medication.
• C. Take the medication with antacids.
• D. Avoid drinking orange juice.

Correct answer: B

Rationale: When a client is prescribed Digoxin, it is essential to monitor their heart rate before each dose. Changes such as a heart rate below 60 bpm should be reported to the healthcare provider promptly. This is crucial because Digoxin can affect heart rhythm, and monitoring the heart rate helps in identifying any potential issues early on.

2. A client informs the nurse about taking Gingko Biloba. Which of the following medications is contraindicated for a client taking Gingko Biloba?

• A. Acetaminophen
• B. Warfarin
• C. Digoxin
• D. Lisinopril

Correct answer: B

Rationale: The correct answer is B, Warfarin. Warfarin is contraindicated for a client taking Gingko Biloba due to the potential interaction. Gingko Biloba can suppress coagulation and increase the risk of bleeding or hemorrhage when taken with anticoagulants like Warfarin. Acetaminophen (choice A), Digoxin (choice C), and Lisinopril (choice D) do not have significant interactions with Gingko Biloba.

3. When starting a new prescription for prednisone, which instruction should the nurse include for the client?

• A. Increase your intake of potassium-rich foods.
• B. Do not stop taking this medication abruptly.
• C. Avoid grapefruit juice while taking this medication.
• D. Take the medication at bedtime to prevent drowsiness.

Correct answer: B

Rationale: The correct instruction for a client starting a new prescription for prednisone is not to stop taking the medication abruptly. Abrupt discontinuation of prednisone can lead to adrenal insufficiency, emphasizing the importance of gradual tapering under healthcare provider guidance. Increasing potassium-rich foods may be necessary based on individual needs, but it is not the priority instruction in this context. Grapefruit juice interaction is more commonly associated with certain medications but not specifically with prednisone. Taking prednisone at bedtime to prevent drowsiness is not a key instruction related to its administration.

4. A client is prescribed furosemide. Which of the following instructions should the nurse include in the teaching?

• A. Take this medication in the morning.
• B. Avoid eating foods high in potassium.
• C. You should take this medication on an empty stomach.
• D. Limit your fluid intake to 1 liter per day.

Correct answer: A

Rationale: The correct instruction for a client prescribed furosemide is to take the medication in the morning. Furosemide, a diuretic, is best taken in the morning to prevent nocturia, which is excessive urination at night. Taking it earlier in the day can help reduce disruptions to sleep patterns. Therefore, advising the client to take furosemide in the morning is crucial for optimal therapeutic effects. Choices B, C, and D are incorrect because furosemide does not require avoiding potassium-rich foods, does not need to be taken on an empty stomach, and does not mandate limiting fluid intake to 1 liter per day.

5. A healthcare professional is reviewing the laboratory results of a client taking Warfarin for atrial fibrillation. Which of the following findings should the professional report to the provider immediately?

• A. INR of 4.0
• B. Potassium level of 4.5 mEq/L
• C. Creatinine level of 1.0 mg/dL
• D. BUN of 18 mg/dL

Correct answer: A

Rationale: An INR of 4.0 indicates that the client's blood is clotting too slowly, increasing the risk of bleeding. This level is above the therapeutic range for a client on Warfarin therapy. Therefore, the healthcare professional should notify the provider immediately to prevent potential bleeding complications. The other laboratory values are within normal limits and do not pose an immediate risk to the client's health while on Warfarin therapy.

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