Nursing Elites

1. When caring for a client prescribed Digoxin, which of the following laboratory values should the nurse monitor to assess for potential toxicity?

• A. Sodium
• B. Potassium
• C. Magnesium
• D. Calcium

Correct answer: B

Rationale: When a client is prescribed Digoxin, monitoring potassium levels is crucial as hypokalemia can increase the risk of Digoxin toxicity. Low potassium levels can potentiate the effects of Digoxin on the heart, leading to toxicity. Therefore, regular monitoring of potassium levels helps in preventing adverse effects and ensuring the safe use of Digoxin. Sodium, magnesium, and calcium levels are not directly associated with Digoxin toxicity; hence, they are not the primary focus for monitoring in this case.

2. A client reports taking Aspirin four times daily for a sprained wrist. Which of the following prescribed medications taken by the client is contraindicated with aspirin?

• A. Digoxin
• B. Metformin
• C. Warfarin
• D. Nitroglycerin

Correct answer: C

Rationale: Aspirin inhibits platelet aggregation, which can increase the effect of anticoagulants like warfarin, leading to an elevated risk of bleeding. Therefore, the concurrent use of aspirin and warfarin is generally contraindicated due to this potential interaction. Digoxin is not contraindicated with aspirin in most cases. Metformin and nitroglycerin do not have significant interactions with aspirin, making them less likely to be contraindicated in this scenario.

3. A client has a new prescription for Hydralazine. Which of the following adverse effects should the nurse instruct the client to monitor?

• A. Tachycardia
• B. Hyperglycemia
• C. Hyponatremia
• D. Constipation

Correct answer: A

Rationale: Corrected Rationale: Hydralazine is a vasodilator that can cause reflex tachycardia as an adverse effect. The client should monitor their pulse and report any significant increases, as tachycardia can indicate a severe adverse reaction to the medication. Choice B, Hyperglycemia, is not a common adverse effect of Hydralazine. Choice C, Hyponatremia, and Choice D, Constipation, are also not typically associated with Hydralazine use. Therefore, the correct answer is A: Tachycardia.

4. Phenytoin is an antiarrhythmic and anticonvulsant that has an unlabeled use for:

• A. Headaches
• B. Cold remedy
• C. Neuropathic pain
• D. Antianxiety

Correct answer: C

Rationale: Phenytoin, an antiarrhythmic and anticonvulsant medication, is also used off-label for treating neuropathic pain. While its primary indications are for managing heart rhythm disorders and seizures, it has shown efficacy in managing neuropathic pain, expanding its clinical utility. Choices A, B, and D are incorrect as phenytoin is not commonly used for headaches, cold remedies, or antianxiety purposes.

5. A client has difficulty swallowing medications and is prescribed enteric-coated aspirin PO once daily. The client asks if the medication can be crushed to make it easier to swallow. Which of the following responses should the nurse provide?

• A. Crushing the medication might cause you to have a stomachache or indigestion.
• B. Crushing the medication is a good idea, and I can mix it in some ice cream for you.
• C. Crushing the medication would release all the medication at once, rather than over time.
• D. Crushing is unsafe, as it destroys the ingredients in the medication.

Correct answer: A

Rationale: Crushing an enteric-coated medication can cause it to break down in the stomach instead of the intestines, potentially leading to gastrointestinal distress like stomachache or indigestion. It is important to take enteric-coated medications whole to ensure they are properly absorbed in the intestines and to prevent irritation to the stomach.

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