Nursing Elites

1. A client with congestive heart failure taking digoxin refused breakfast and is complaining of nausea and weakness. Which action should the nurse take first?

• A. Check the client's vital signs.
• B. Request a consult with a dietitian.
• C. Suggest that the client rests before eating the meal.
• D. Request an order for an antiemetic.

Correct answer: A

Rationale: The nurse should check the client's vital signs first because nausea and weakness can be signs of digoxin toxicity. Vital signs can provide immediate information on the client's condition and help guide further interventions. Monitoring vital signs will allow the nurse to assess for bradycardia, a common sign of digoxin toxicity. Requesting a dietitian consult (choice B) may be necessary but addressing the immediate concern of toxicity is the priority. Suggesting rest before eating (choice C) may not address the underlying issue of digoxin toxicity. Requesting an antiemetic (choice D) can be considered later but is not the initial action needed in this situation.

2. A client has been prescribed Aspirin for prevention of cardiovascular disease. Which of the following findings indicates the medication is effective?

• A. The client has a decrease in troponin levels.
• B. The client has a regular heart rhythm.
• C. The client experiences a decrease in episodes of angina.
• D. The client's blood pressure remains stable.

Correct answer: C

Rationale: The correct answer is C. A decrease in episodes of angina is an indicator of Aspirin's effectiveness in preventing cardiovascular events. Aspirin works by inhibiting platelet aggregation, thereby reducing the formation of blood clots that could lead to angina episodes or more severe cardiovascular complications. Choices A, B, and D are incorrect because troponin levels, heart rhythm, and blood pressure are not direct indicators of Aspirin's effectiveness in preventing cardiovascular events.

3. A healthcare professional is preparing to administer Haloperidol 2 mg PO every 12 hr. The available dosage is haloperidol 1 mg/tablet. How many tablets should the healthcare professional administer?

• A. 1 tablet
• B. 2 tablets
• C. 3 tablets
• D. 4 tablets

Correct answer: B

Rationale: To determine the number of tablets needed, divide the desired dose by the dose per tablet. In this case, (2 mg / 1 mg/tablet) = 2 tablets required to administer the prescribed dose of Haloperidol.

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

• A. Take the medication with food.
• B. Monitor your blood pressure weekly.
• C. Notify your provider if you develop a persistent cough.
• D. Avoid using salt substitutes to prevent hyperkalemia.

Correct answer: C

Rationale: Clients prescribed with Captopril, an ACE inhibitor, are at risk of developing a persistent cough as a common adverse effect. It is essential for the client to inform their healthcare provider promptly if this side effect occurs to evaluate the need for a medication change or adjustment.

5. A healthcare provider plans to administer Morphine IV to a postoperative client. Which of the following actions should the provider take?

• A. Monitor for seizures and confusion with repeated doses.
• B. Protect the client's skin from severe diarrhea associated with morphine.
• C. Withhold this medication if the respiratory rate is less than 12/min.
• D. Administer Morphine intermittently via IV bolus over 30 seconds or less.

Correct answer: C

Rationale: The correct action for the provider is to withhold morphine if the client's respiratory rate is 12/min or less. Respiratory depression is a serious side effect of morphine and other opioids. Withholding the medication and informing the healthcare provider is essential to prevent further respiratory compromise in the client. Choices A, B, and D are incorrect because monitoring for seizures and confusion, protecting the client's skin from severe diarrhea, and administering morphine via IV bolus over 30 seconds or less are not the primary actions to ensure client safety when administering morphine IV. Respiratory status is crucial due to the risk of respiratory depression associated with opioid administration.

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