Nursing Elites

1. A healthcare provider is reviewing the client's history before administering opioid pain medication. Which of the following conditions is a contraindication to opioid therapy?

• A. Asthma
• B. Renal failure
• C. Diabetes mellitus
• D. Obesity

Correct answer: B

Rationale: Renal failure is a contraindication to opioid therapy due to the risk of drug accumulation and toxicity. Asthma, diabetes mellitus, and obesity are not contraindications to opioid therapy. Asthma is a respiratory condition that can be managed alongside opioids, diabetes mellitus and obesity do not directly contraindicate opioid therapy.

2. A client is prescribed digoxin 0.125 mg daily for heart failure. Which of the following client reports should concern the nurse as a sign of digoxin toxicity?

• A. Increased appetite
• B. Visual disturbances
• C. Weight gain
• D. Constipation

Correct answer: B

Rationale: Visual disturbances such as blurred vision or seeing halos around lights are common signs of digoxin toxicity. Increased appetite, weight gain, and constipation are not typically associated with digoxin toxicity. Weight gain could be a sign of worsening heart failure rather than digoxin toxicity. Increased appetite and constipation are not specific signs of digoxin toxicity and are less likely to be related.

3. A nurse is caring for a client newly prescribed doxazosin mesylate. Which of the following instructions should the nurse include in client education regarding taking the first dose of this medication?

• A. Change positions slowly and lie down if dizziness occurs
• B. There is no need to avoid normal activities
• C. Avoid dairy products while taking this medication
• D. Do not eat green leafy vegetables

Correct answer: A

Rationale: Corrected Rationale: First-dose orthostatic hypotension can occur with doxazosin. The nurse should advise the client to change positions slowly and lie down if dizziness occurs. Choice B is incorrect because it does not address the potential side effect of dizziness. Choice C and D are also incorrect as there is no specific dietary restriction related to doxazosin mesylate.

4. A nurse is caring for a client receiving theophylline for chronic obstructive pulmonary disease (COPD). Which of the following client findings indicates the need for immediate intervention?

• A. Productive cough
• B. Drowsiness
• C. Vomiting
• D. Polyuria

Correct answer: D

Rationale: Polyuria is a sign of theophylline toxicity and requires immediate intervention. Theophylline toxicity can lead to serious complications, and polyuria is a concerning symptom that indicates the need for urgent medical attention. Productive cough, drowsiness, and vomiting are common side effects of theophylline but are not typically indicative of immediate life-threatening issues like polyuria in the context of theophylline toxicity.

5. A nurse is caring for a client prescribed enoxaparin for deep vein thrombosis prophylaxis. Which of the following client assessments requires immediate intervention?

• A. Platelet count of 95,000/mm³
• B. Blood pressure of 145/90 mmHg
• C. Heart rate of 95 beats per minute
• D. Pain at the injection site

Correct answer: A

Rationale: A platelet count of 95,000/mm³ requires immediate intervention as it is low and increases the risk of bleeding, which is a potential complication of enoxaparin therapy. Low platelet counts can predispose the patient to hemorrhage, and administering anticoagulants like enoxaparin in such cases can further increase the bleeding risk. Monitoring platelet counts is crucial during anticoagulant therapy to prevent serious bleeding complications. The other options do not pose immediate risks related to enoxaparin therapy. A slightly elevated blood pressure, a heart rate of 95 beats per minute, and pain at the injection site are common findings that may not warrant immediate intervention in this context.

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