Nursing Elites

1. A nurse is providing discharge teaching to a client who has heart failure and a new prescription for digoxin 0.215 mg PO daily and furosemide 20 mg PO daily. Which of the following statements by the client indicates an understanding of the teaching?

• A. I know that blurred vision is something I will expect to happen while taking digoxin.
• B. I will measure my urine output each day and document it in my diary.
• C. I will skip a dose of my digoxin if my resting heart rate is below 72 beats per minute.
• D. I will eat fruits and vegetables that have high potassium content every day.

Correct answer: D

Rationale: Clients taking digoxin and furosemide are at risk for hypokalemia. Eating potassium-rich foods can help maintain normal potassium levels.

2. A nurse on a medical unit is preparing to administer alendronate 40 mg PO for an older adult client who has Paget's disease of the bone. Which of the following actions should be the nurse's priority?

• A. Administer the medication to the client before breakfast in the morning.
• B. Assist the client to a chair before administering the medication.
• C. Give the medication to the client with water rather than milk.
• D. Educate the client on how to take the medication at home.

Correct answer: A

Rationale: The correct answer is to administer the medication to the client before breakfast in the morning. Alendronate should be taken on an empty stomach before breakfast to ensure optimal absorption. Choice B is incorrect because assisting the client to a chair is not directly related to the administration of alendronate. Choice C is incorrect as there is no specific requirement to avoid taking alendronate with milk. Choice D is also incorrect as the priority at this moment is the correct administration of the medication in the hospital setting.

3. A nurse is caring for an older adult client who has a new prescription for amitriptyline to treat depression. Which of the following diagnostic tests should the nurse plan to perform prior to starting the client on this medication?

• A. Hearing examination
• B. Glucose tolerance test
• C. Electrocardiogram
• D. Pulmonary function tests

Correct answer: C

Rationale: The correct answer is C: Electrocardiogram. Amitriptyline can cause cardiac arrhythmias, so an electrocardiogram is necessary before starting treatment. A hearing examination (choice A) is not required before initiating amitriptyline. A glucose tolerance test (choice B) is not indicated for starting this medication. Pulmonary function tests (choice D) are not necessary before initiating amitriptyline for depression.

4. A nurse is caring for a client who has a new prescription for amphotericin B. The nurse should plan to monitor the client for which of the following adverse effects?

• A. Hyperkalemia
• B. Hypertension
• C. Constipation
• D. Nephrotoxicity

Correct answer: D

Rationale: Correct. Amphotericin B is known for its nephrotoxicity, which can lead to kidney damage. Monitoring kidney function is crucial to detect any signs of nephrotoxicity early. Choices A, B, and C are incorrect because hyperkalemia, hypertension, and constipation are not typically associated with amphotericin B use. Therefore, the nurse should focus on monitoring for nephrotoxicity.

5. A nurse is caring for a client who has been taking isoniazid and rifampin for 3 weeks for the treatment of active pulmonary tuberculosis (TB). The client reports his urine is an orange color. Which of the following statements should the nurse make?

• A. Stop taking the isoniazid for 3 days and the discoloration should go away.
• B. Rifampin can turn body fluids orange.
• C. I'll make an appointment for you to see the provider this afternoon.
• D. Isoniazid can cause bladder irritation.

Correct answer: B

Rationale: The correct answer is B: 'Rifampin can turn body fluids orange.' Rifampin is known to cause orange discoloration of body fluids, including urine. This side effect is harmless and does not indicate a need to stop the medication. Choice A is incorrect because stopping isoniazid will not resolve the orange urine discoloration caused by rifampin. Choice C is unnecessary at this point since the orange urine is a known side effect of rifampin and does not require an urgent provider visit. Choice D is incorrect because bladder irritation is not typically associated with isoniazid.

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