Nursing Elites

1. A healthcare professional is reviewing laboratory results for a client who has been taking carbamazepine. Which of the following findings should the healthcare professional report to the provider?

• A. WBC count 3,000/mm3
• B. Platelet count 150,000/mm3
• C. Hemoglobin 14 g/dL
• D. Serum potassium 4.5 mEq/L

Correct answer: A

Rationale: A WBC count of 3,000/mm3 indicates leukopenia, a serious side effect of carbamazepine. Leukopenia can increase the risk of infections due to decreased white blood cell count, which is important to report to the provider for further evaluation and management. Platelet count within normal range (choice B), hemoglobin level within normal range (choice C), and serum potassium level within normal range (choice D) are not directly associated with carbamazepine use and do not require immediate reporting as they do not indicate a serious adverse effect.

2. A nurse is assessing a client who has been taking levothyroxine for hypothyroidism. Which of the following findings should the nurse report to the provider?

• A. Weight loss
• B. Insomnia
• C. Heat intolerance
• D. Dry skin

Correct answer: C

Rationale: The correct answer is C: Heat intolerance. Heat intolerance is a sign of levothyroxine toxicity and requires immediate attention. Weight loss may actually be an expected outcome of levothyroxine therapy as it can help regulate metabolism in hypothyroidism. Insomnia can occur as a side effect of levothyroxine but is not as concerning as heat intolerance. Dry skin is a common symptom of hypothyroidism and may improve with levothyroxine therapy, so it is not a priority finding to report to the provider.

3. A healthcare provider is providing discharge teaching to a client who has a new prescription for furosemide. Which of the following statements should the provider include?

• A. Expect muscle pain.
• B. Monitor your weight daily.
• C. Avoid consuming grapefruit juice.
• D. Increase your intake of potassium-rich foods.

Correct answer: D

Rationale: When a client is prescribed furosemide, an important consideration is preventing hypokalemia, a potential side effect of the medication. Furosemide can lead to potassium depletion, so increasing the intake of potassium-rich foods is crucial to maintain adequate potassium levels in the body. Choices A, B, and C are incorrect because muscle pain is not a common side effect of furosemide, monitoring weight daily may not be directly related to the medication, and avoiding grapefruit juice is more relevant for certain medications that interact with grapefruit juice, not furosemide.

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

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

Correct answer: B

Rationale: Corrected Rationale: Bradycardia is a common sign of digoxin toxicity. Digoxin can cause bradycardia due to its effects on the heart's electrical conduction system. Monitoring for a slow heart rate is crucial as it indicates potential toxicity. Hypertension, hyperglycemia, and insomnia are not typically associated with digoxin toxicity. Hypertension is more commonly seen in other conditions, hyperglycemia is not a typical sign of digoxin toxicity, and insomnia is not a recognized symptom of digoxin toxicity.

5. The nurse is caring for a client diagnosed with deep vein thrombosis (DVT). Which intervention should the nurse include in the client's plan of care to prevent the complication of pulmonary embolism?

• A. Encourage ambulation as tolerated.
• B. Administer anticoagulants as prescribed.
• C. Apply cold compresses to the affected area.
• D. Encourage the use of incentive spirometry.

Correct answer: B

Rationale: Administering anticoagulants as prescribed is crucial in preventing the complication of pulmonary embolism in clients with deep vein thrombosis. Anticoagulants help prevent the formation of new clots and the enlargement of existing ones, thereby reducing the risk of a pulmonary embolism. Encouraging ambulation as tolerated is beneficial for preventing complications related to immobility, but it is not the primary intervention to prevent pulmonary embolism in this case. Applying cold compresses to the affected area may help with pain and swelling but does not address the prevention of pulmonary embolism. Encouraging the use of incentive spirometry is more relevant in preventing respiratory complications such as atelectasis, not specifically pulmonary embolism.

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