Nursing Elites

1. A nurse is caring for a client who is 1 day postoperative following a total knee replacement. Which of the following findings should the nurse report to the provider?

• A. Heart rate of 88/min
• B. Serous drainage on the dressing
• C. Temperature 37.3°C (99.1°F)
• D. Calf pain on dorsiflexion

Correct answer: D

Rationale: The correct answer is D. Calf pain on dorsiflexion following knee surgery may indicate a complication such as deep vein thrombosis, which is a serious condition requiring medical attention. Reporting this finding promptly is crucial to prevent further complications. Choices A, B, and C are within normal range for a client post knee surgery and do not typically indicate immediate complications that require urgent reporting.

2. A nurse is providing teaching to a client who has been prescribed digoxin for heart failure. Which of the following instructions should the nurse include?

• A. Take this medication with meals.
• B. Check your pulse before taking this medication.
• C. Take this medication with an antacid to reduce stomach upset.
• D. Increase your potassium intake while taking this medication.

Correct answer: B

Rationale: The correct answer is B: 'Check your pulse before taking this medication.' When a patient is prescribed digoxin, it is crucial to monitor their pulse rate because digoxin can cause bradycardia (slow heart rate) as a side effect. In contrast, choices A, C, and D are incorrect. Taking digoxin with meals is not necessary; it should be taken consistently at the same time every day. Taking digoxin with an antacid is not recommended as it can interfere with the absorption of the medication. While digoxin can cause hypokalemia (low potassium levels), patients should not increase their potassium intake without healthcare provider guidance to avoid potential complications.

3. A client with a new diagnosis of hypertension is receiving discharge teaching. Which statement by the client indicates an understanding of the teaching?

• A. I will take my medication only when I feel dizzy.
• B. I will check my blood pressure at least once a week.
• C. I will limit my saturated fat intake to 7% of daily calories.
• D. I will take my medication only when I have symptoms.

Correct answer: C

Rationale: The correct answer is C because limiting saturated fat intake to 7% of daily calories is a crucial component of the dietary management for hypertension. This dietary modification helps reduce the risk of cardiovascular complications. Choices A, B, and D are incorrect. Choice A is incorrect because medication adherence should not be based on symptoms like dizziness. Choice B is inadequate as blood pressure monitoring should be more frequent, preferably daily, for effective management of hypertension. Choice D is incorrect because medication for hypertension should be taken consistently as prescribed, not just when symptoms occur.

4. How should fluid balance be assessed in a patient with heart failure?

• A. Monitor daily weight
• B. Monitor input and output
• C. Check for edema
• D. Monitor blood pressure

Correct answer: A

Rationale: In patients with heart failure, monitoring daily weight is the most accurate method for assessing fluid balance. Weight gain can indicate fluid retention, a common issue in heart failure patients. Monitoring input and output (B) is essential but may not always accurately reflect fluid balance. Checking for edema (C) is important as it can indicate fluid accumulation, but daily weight monitoring is more precise. Monitoring blood pressure (D) is important in heart failure management but does not directly assess fluid balance.

5. How should a healthcare provider monitor a patient who has been prescribed digoxin?

• A. Monitor potassium levels
• B. Monitor heart rate
• C. Check digoxin levels
• D. Check blood glucose levels

Correct answer: C

Rationale: The correct way to monitor a patient who has been prescribed digoxin is by checking digoxin levels. Digoxin is a medication used to treat various heart conditions, and monitoring its levels in the blood is crucial to prevent toxicity. Monitoring potassium levels (Choice A) is important as well, as digoxin can affect potassium levels, but checking digoxin levels is more specific to monitoring the medication itself. Monitoring heart rate (Choice B) is relevant but does not directly assess the medication levels. Checking blood glucose levels (Choice D) is not typically indicated specifically for patients prescribed digoxin.

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