Nursing Elites

1. A client has a new prescription for furosemide. Which of the following instructions should the nurse include?

• A. Take the medication with or without food.
• B. Monitor for signs of hypokalemia.
• C. Increase your intake of potassium-rich foods.
• D. Expect an increase in urination.

Correct answer: D

Rationale: The correct instruction to include when a client is prescribed furosemide is to expect an increase in urination. Furosemide is a diuretic that works by increasing urine production, so it is essential for the client to anticipate and understand this effect. Monitoring for signs of hypokalemia and increasing potassium-rich foods are not directly related to furosemide use. Hypokalemia is a potential side effect of furosemide, so monitoring for it is crucial. Increasing potassium-rich foods can help counteract potassium loss due to diuretic use. Taking furosemide with food is not required, as it can be taken with or without food.

2. The nurse is caring for a client diagnosed with heart failure who is taking digoxin (Lanoxin). Which sign of digoxin toxicity should the nurse monitor for?

• A. Hypertension
• B. Bradycardia
• C. Hyperglycemia
• D. Insomnia

Correct answer: B

Rationale: The correct answer is B: Bradycardia. Bradycardia is a common sign of digoxin toxicity, as digoxin can cause decreased heart rate. Therefore, monitoring the client for signs of bradycardia is crucial. Choices A, C, and D are incorrect. Hypertension is not typically associated with digoxin toxicity; instead, hypotension may occur. Hyperglycemia is not a common sign of digoxin toxicity. Insomnia is also not a typical sign of digoxin toxicity; instead, some patients may experience visual disturbances, confusion, or other neurological symptoms.

3. Prior to a dipyridamole thallium scan, what substance should the LPN/LVN ensure the client has not consumed?

• A. Caffeine
• B. Fatty meal
• C. Excess sugar
• D. Milk products

Correct answer: A

Rationale: Caffeine should be avoided before a dipyridamole thallium scan as it can interfere with the test results. Caffeine is a stimulant that can affect the heart rate and may lead to inaccurate findings during the scan. Fatty meals, excess sugar, and milk products do not specifically interfere with the dipyridamole thallium scan procedure. Therefore, it is essential for the LPN/LVN to check and ensure that the client has not consumed caffeine prior to the procedure to obtain accurate diagnostic results.

4. A 24-year-old man seeks medical attention for complaints of claudication in the arch of the foot. The nurse also notes superficial thrombophlebitis of the lower leg. What should the nurse check the client for next?

• A. Smoking history
• B. Recent exposure to allergens
• C. History of recent insect bites
• D. Familial tendency toward peripheral vascular disease

Correct answer: A

Rationale: In this case, the nurse should check the client's smoking history next. Smoking is a significant risk factor for peripheral vascular disease, leading to the development of thrombophlebitis and claudication. It is important to assess this risk factor as it can significantly impact the client's vascular health and the progression of their current symptoms. Choices B, C, and D are incorrect because they are not directly related to the symptoms described by the client. Recent exposure to allergens or insect bites would typically present with different symptoms, and familial tendency toward peripheral vascular disease is not the immediate concern in this case.

5. A client has a new prescription for metformin. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Monitor for signs of hypoglycemia.
• C. Increase fluid intake.
• D. Expect a metallic taste in the mouth.

Correct answer: C

Rationale: The correct instruction for a client starting metformin is to increase fluid intake. This is crucial to prevent gastrointestinal discomfort, a common side effect of metformin. Adequate hydration can also help reduce the risk of kidney problems associated with metformin use. Choices A, B, and D are incorrect. While it's generally recommended to take metformin with food to reduce stomach upset, monitoring for signs of hypoglycemia is more relevant for other antidiabetic medications, and a metallic taste in the mouth is not a common side effect of metformin.

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