Nursing Elites

1. When providing teaching to a client with a new prescription for digoxin, which of the following instructions should the nurse include?

• A. Take your pulse before taking the medication.
• B. Take the medication with an antacid.
• C. Double the dose if you miss one.
• D. Take the medication with a high-fiber meal.

Correct answer: A

Rationale: The correct instruction for a client with a new prescription for digoxin is to take their pulse before taking the medication. Digoxin can lead to bradycardia as a side effect, and monitoring the pulse helps in assessing the heart rate prior to medication administration. This precaution allows for the identification of any significant changes in heart rate that may require medical attention.

2. A client with meningitis is being assessed by a healthcare provider. Which of the following findings should the provider expect?

• A. Negative Brudzinski’s sign.
• B. Flaccid neck muscles.
• C. Petechial rash.
• D. Hypoactive deep tendon reflexes.

Correct answer: C

Rationale: A petechial rash is a characteristic finding in clients with meningitis, indicating small, pinpoint hemorrhages under the skin. This rash results from the infection's impact on the blood vessels. Petechiae are important to recognize as they can help differentiate meningitis from other conditions with similar symptoms. Brudzinski’s sign, neck stiffness, and positive Kernig’s sign are more common physical exam findings in meningitis. Flaccid neck muscles and hypoactive deep tendon reflexes are not typically associated with meningitis.

3. A client with gout is being taught about dietary management. Which of the following statements by the client indicates an understanding of the teaching?

• A. I should increase my intake of purine-rich foods.
• B. I should decrease my intake of purine-rich foods.
• C. I should increase my intake of sodium-rich foods.
• D. I should decrease my intake of potassium-rich foods.

Correct answer: B

Rationale: The correct answer is B. Decreasing the intake of purine-rich foods is essential in managing gout as purines break down into uric acid, contributing to gout symptoms. Increasing purine-rich foods would exacerbate the condition by increasing uric acid levels. Therefore, choice A is incorrect. Choices C and D are also incorrect as increasing sodium-rich foods (choice C) is not recommended for gout management, and decreasing potassium-rich foods (choice D) is unrelated to gout.

4. A client with osteoporosis is being taught about dietary management. Which statement indicates an understanding of the teaching?

• A. I should increase my intake of foods high in vitamin D.
• B. I should decrease my intake of foods high in calcium.
• C. I should increase my intake of foods high in phosphorus.
• D. I should decrease my intake of foods high in potassium.

Correct answer: A

Rationale: The correct answer is A. Increasing intake of foods high in vitamin D is beneficial for improving calcium absorption and managing osteoporosis. Vitamin D helps the body absorb calcium, which is essential for bone health and can aid in managing osteoporosis effectively. Choice B is incorrect because reducing calcium intake would be counterproductive for a client with osteoporosis, as calcium is crucial for bone strength. Choice C is incorrect as phosphorus, while important for bone health, does not directly impact osteoporosis management as much as vitamin D and calcium. Choice D is incorrect as potassium is not directly linked to osteoporosis management, and reducing its intake is not typically part of dietary recommendations for osteoporosis.

5. A client has been prescribed enoxaparin. Which of the following instructions should the nurse include?

• A. You need to obtain routine blood tests to monitor the effects of this medication.
• B. You should administer the medication into your thigh.
• C. You should inject the medication once daily.
• D. You need to use a 1-inch needle to administer the medication.

Correct answer: C

Rationale: The correct instruction to include when educating a client prescribed enoxaparin is to inject the medication once daily. Enoxaparin is typically administered via subcutaneous injection once daily, usually in the abdomen, to prevent blood clots.

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