Nursing Elites

1. A client with heart failure is prescribed digoxin. Which of the following findings should the nurse identify as an adverse effect of digoxin?

• A. Constipation
• B. Blurred vision
• C. Nausea
• D. Headache

Correct answer: B

Rationale: Blurred vision is a common adverse effect of digoxin and can indicate toxicity. Monitoring for visual changes is essential to prevent serious complications in clients taking digoxin.

2. A client with Diabetes is experiencing Nausea due to Gastroparesis. The healthcare provider should anticipate a prescription for which of the following medications?

• A. Lubiprostone
• B. Metoclopramide
• C. Bisacodyl
• D. Loperamide

Correct answer: B

Rationale: Metoclopramide, a dopamine antagonist, is indicated for treating nausea and increasing gastric motility. In the context of diabetic gastroparesis, it can alleviate bloating and nausea by enhancing gastric emptying. Lubiprostone (Choice A) is a chloride channel activator used for chronic idiopathic constipation and irritable bowel syndrome with constipation. Bisacodyl (Choice C) is a stimulant laxative primarily used for constipation. Loperamide (Choice D) is an anti-diarrheal agent and would not be appropriate for treating nausea and gastroparesis.

3. A healthcare provider is preparing to administer metoprolol to a client. Which of the following findings should the provider identify as a contraindication to receiving this medication?

• A. Bradycardia
• B. Hypertension
• C. Fever
• D. Rash

Correct answer: A

Rationale: Metoprolol, a beta-blocker, is contraindicated in clients with bradycardia as it can further lower the heart rate, potentially leading to more serious complications. Bradycardia is defined as a heart rate below 60 beats per minute, and administering metoprolol in such cases can exacerbate this condition, causing adverse effects on cardiac output. Hypertension, fever, and rash are not contraindications for metoprolol administration.

4. A healthcare provider is caring for a group of individuals who are not immune to Varicella. The healthcare provider should prepare to administer the Varicella vaccine at this time to which of the following individuals?

• A. 24-year-old woman in the third trimester of pregnancy
• B. 12-year-old child who has a severe allergy to neomycin
• C. 2-month-old infant who has no health problems
• D. 32-year-old man who has essential hypertension

Correct answer: D

Rationale: The correct answer is the 32-year-old man with essential hypertension. Individuals not immune to Varicella should receive the vaccine if they did not get two doses earlier. Essential hypertension is not a contraindication for the Varicella vaccine. Administering the vaccine to pregnant women, individuals with severe neomycin allergies, or infants is contraindicated. Pregnant women should not receive the Varicella vaccine due to the potential risk to the fetus. Severe neomycin allergies are a contraindication because neomycin is present in the vaccine. Infants under 12 months of age are generally not vaccinated against Varicella unless there are specific circumstances or recommendations.

5. A client has a new prescription for radioactive iodine to treat Hyperthyroidism. Which of the following instructions should the nurse include?

• A. Expect a metallic taste in the mouth.
• B. Avoid contact with pregnant women for 1 week.
• C. Administer iodine solution using a straw.
• D. Take thyroid replacement medication for 3 weeks after treatment.

Correct answer: B

Rationale: When a client undergoes radioactive iodine treatment for hyperthyroidism, they can emit radiation for a short time. To prevent radiation exposure to others, especially pregnant women, infants, and small children, clients should avoid close contact for about 1 week following therapy. This precaution is essential to protect vulnerable individuals from potential harm. Choice A is incorrect because a metallic taste in the mouth is not a common side effect of radioactive iodine treatment. Choice C is incorrect because administering iodine solution using a straw is not a standard practice in this treatment. Choice D is incorrect because taking thyroid replacement medication for 3 weeks after treatment is not a typical instruction associated with radioactive iodine therapy for hyperthyroidism.

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