Nursing Elites

1. A client has a prescription for digoxin. The client should be monitored for which of the following findings as an indication of digoxin toxicity?

• A. Visual disturbances
• B. Tachycardia
• C. Increased appetite
• D. Constipation

Correct answer: A

Rationale: Visual disturbances, such as yellow-tinged vision or seeing halos around lights, are common signs of digoxin toxicity. These symptoms should be reported immediately to healthcare providers for further evaluation and management. Tachycardia (Choice B) is not typically associated with digoxin toxicity. Increased appetite (Choice C) and constipation (Choice D) are not common manifestations of digoxin toxicity. Therefore, the correct answer is visual disturbances.

2. When providing teaching to a client starting therapy with trastuzumab, which finding should the nurse instruct the client to report?

• A. Dyspnea
• B. Constipation
• C. Tinnitus
• D. Dry mouth

Correct answer: A

Rationale: The correct answer is A: Dyspnea. The nurse should instruct the client to report dyspnea because it can indicate pulmonary toxicity, a serious adverse effect of trastuzumab. Monitoring and early reporting of respiratory symptoms like dyspnea are essential to prevent further complications and ensure timely intervention. Choices B, C, and D are incorrect because constipation, tinnitus, and dry mouth are not typically associated with trastuzumab therapy and are not priority symptoms that require immediate reporting for this specific medication.

3. A healthcare professional is preparing to administer heparin 15,000 units subcutaneously every 12 hr. The amount available is heparin injection 20,000 units/mL. How many mL should the healthcare professional administer per dose?

• A. 0.8 mL
• B. 0.75 mL
• C. 0.5 mL
• D. 1 mL

Correct answer: A

Rationale: To calculate the volume to administer, use the formula: (Desired dose / Concentration) = Volume to administer. In this case, (15,000 units / 20,000 units/mL) = 0.75 mL, which is rounded up to 0.8 mL. Therefore, the healthcare professional should administer 0.8 mL per dose of heparin. Choice B (0.75 mL) is incorrect as it is the exact calculated volume but needs to be rounded up. Choices C (0.5 mL) and D (1 mL) are incorrect as they do not reflect the correct calculated volume for the desired dose of heparin.

4. A client has a new prescription for Levofloxacin. Which of the following instructions should be included in the discharge instructions?

• A. Take this medication with food.
• B. Avoid taking this medication with dairy products.
• C. Take this medication at bedtime.
• D. Increase your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct answer is B: 'Avoid taking this medication with dairy products.' Levofloxacin should not be taken with dairy products because calcium can interfere with the absorption of the medication. It is recommended to take Levofloxacin 1 hour before or 2 hours after consuming dairy products to ensure optimal absorption and effectiveness of the medication. Choices A, C, and D are incorrect. Choice A is not recommended as Levofloxacin is usually taken on an empty stomach. Choice C is not necessary information for taking Levofloxacin. Choice D is unrelated to the administration of Levofloxacin.

5. When completing a nursing history for a client taking Simvastatin, which of the following disorders should the nurse identify as a contraindication to adding Ezetimibe to the client's medications?

• A. History of severe constipation
• B. History of hypertension
• C. Active hepatitis C
• D. Type 2 diabetes mellitus

Correct answer: C

Rationale: Ezetimibe is contraindicated in clients with active moderate-to-severe liver disorders, particularly if they are already on a statin like simvastatin. Hepatitis C is a liver condition that can be exacerbated by Ezetimibe, leading to potential complications. Therefore, the nurse should identify active hepatitis C as a contraindication to adding Ezetimibe to the client's medications. Choices A, B, and D are incorrect because they are not directly related to the contraindication of Ezetimibe in clients taking Simvastatin.

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