Nursing Elites

1. A nurse is caring for a client who is receiving IV diltiazem for atrial fibrillation. Which of the following findings is a contraindication to the administration of diltiazem?

• A. Hypotension
• B. Tachycardia
• C. Decreased level of consciousness
• D. History of diuretic use

Correct answer: A

Rationale: The correct answer is A: Hypotension. Diltiazem can cause further lowering of blood pressure, so it should not be administered if the client is already hypotensive. Monitoring blood pressure is crucial before giving diltiazem. Choice B, tachycardia, is not a contraindication for diltiazem use; in fact, diltiazem is used to slow down the heart rate. Choice C, decreased level of consciousness, may indicate other issues but is not a direct contraindication for diltiazem. Choice D, history of diuretic use, is not a contraindication by itself; however, caution should be exercised when diltiazem is given with diuretics due to potential interactions.

2. A nurse is providing education on the use of calcium carbonate. Which of the following should be included?

• A. It can cause hypocalcemia
• B. Monitor for constipation
• C. It can be taken anytime
• D. It is a prescription medication

Correct answer: B

Rationale: The correct answer is B: 'Monitor for constipation.' Calcium carbonate can cause constipation as a side effect. Educating clients on dietary adjustments, such as increasing fluid intake and fiber consumption, can help alleviate this issue. Choice A is incorrect because calcium carbonate supplementation is used to treat hypocalcemia, not cause it. Choice C is incorrect because calcium carbonate should be taken with food for optimal absorption. Choice D is incorrect because calcium carbonate is available over the counter, not as a prescription medication.

3. A nurse in a provider's office is assessing a client who reports a decrease in the effectiveness of their arthritis medication. Which of the following client information should the nurse identify as a contributing factor?

• A. The client has a history of recurring bowel inflammation.
• B. The client has recently increased their exercise regimen.
• C. The client is taking herbal supplements.
• D. The client is experiencing increased stress.

Correct answer: A

Rationale: The correct answer is A. Recurring bowel inflammation can decrease gastrointestinal motility, affecting the absorption of oral medications. This can lead to decreased effectiveness of the arthritis medication. Choice B is incorrect because increasing exercise would not typically impact the absorption of arthritis medication. Choice C is incorrect as herbal supplements may not directly affect the absorption of conventional arthritis medication. Choice D is also incorrect as stress, while it can impact overall health, is less likely to directly affect the effectiveness of arthritis medication compared to gastrointestinal issues.

4. A client is prescribed digoxin and has a potassium level of 3.0 mEq/L. Which of the following actions should the nurse take?

• A. Administer digoxin without any modifications
• B. Administer the medication at a lower dose
• C. Monitor serum potassium levels
• D. Discontinue the medication if potassium levels rise

Correct answer: A

Rationale: A potassium level of 3.0 mEq/L indicates hypokalemia, which increases the risk of digoxin toxicity. In this case, the nurse should administer the digoxin without any modifications. Lowering the dose (Choice B) may not be necessary if the potassium level is not critically low. Monitoring serum potassium levels (Choice C) is important but should not delay the administration of digoxin. Discontinuing the medication (Choice D) is not the initial action to take unless the potassium levels become severely low and life-threatening.

5. A client newly diagnosed with nephrotic syndrome is being taught by a nurse. Which statement indicates that the client understands the teaching?

• A. “I can expect swelling in my hands and on my face.”
• B. “The amount of protein in my blood is high.”
• C. “I might have some pain and gas in my stomach from this condition.”
• D. “I will use a soft bristle toothbrush, so my gums don’t bleed.”

Correct answer: A

Rationale: The correct answer is A: “I can expect swelling in my hands and on my face.” Nephrotic syndrome leads to increased permeability of the glomeruli, resulting in edema, especially in the face and dependent areas. Choice B is incorrect because nephrotic syndrome leads to protein loss in the urine, not an increase in blood protein levels. Choice C is incorrect as stomach pain and gas are not typical symptoms of nephrotic syndrome. Choice D is unrelated to the teaching about nephrotic syndrome and gum bleeding.

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