Nursing Elites

1. A healthcare provider is reviewing the laboratory report of a client with a prescription for digoxin. Which result requires withholding the medication?

• A. Digoxin 0.8 ng/mL
• B. Sodium 145 mEq/L
• C. BUN 20 mg/dL
• D. Potassium 3.1 mEq/L

Correct answer: D

Rationale: The correct answer is D. A low potassium level (3.1 mEq/L) can increase the risk of digoxin toxicity. Hypokalemia can potentiate the effects of digoxin on the heart, leading to serious dysrhythmias. Choices A, B, and C are within normal ranges and do not indicate a need to withhold digoxin.

2. A nurse is planning care for a client who has osteoarthritis. Which of the following interventions should the nurse include?

• A. Administer opioids routinely for chronic pain.
• B. Instruct the client to avoid weight-bearing exercises.
• C. Apply heat to affected joints to reduce stiffness.
• D. Avoid physical activity to prevent joint damage.

Correct answer: C

Rationale: The correct intervention for a client with osteoarthritis is to apply heat to affected joints to reduce stiffness. Heat application helps improve circulation, relax muscles, and reduce discomfort in joints affected by osteoarthritis. Administering opioids routinely (Choice A) is not the first-line treatment for osteoarthritis and carries risks of dependency and side effects. Instructing the client to avoid weight-bearing exercises (Choice B) may lead to muscle weakness and reduced joint flexibility. Avoiding physical activity altogether (Choice D) can lead to further joint stiffness and compromised overall health.

3. A nurse is caring for a client who has pneumonia. Which of the following findings should the nurse report to the provider immediately?

• A. Increased appetite
• B. Productive cough with green sputum
• C. Cyanosis of the lips and nail beds
• D. Mild shortness of breath

Correct answer: C

Rationale: The correct answer is C: Cyanosis of the lips and nail beds. Cyanosis is a late sign of hypoxia and indicates severe oxygen deprivation, requiring immediate intervention in clients with pneumonia. Reporting this finding promptly is crucial to prevent further complications. Choices A, B, and D are incorrect because increased appetite, productive cough with green sputum, and mild shortness of breath are common findings in clients with pneumonia and may not require immediate intervention unless they worsen or are accompanied by other concerning symptoms.

4. A nurse is caring for a client who is postoperative following a total knee arthroplasty. Which of the following actions should the nurse take?

• A. Place a pillow under the client's knees
• B. Keep the client's legs elevated
• C. Flex the client's knee every 2 hours
• D. Apply heat to the operative knee

Correct answer: B

Rationale: Keeping the client's legs elevated is the appropriate action to prevent venous thromboembolism following a total knee arthroplasty. Elevating the legs helps promote circulation and reduce the risk of blood clots. Placing a pillow under the client's knees may provide comfort but does not address the specific postoperative complication. Flexing the client's knee every 2 hours may be contraindicated as excessive movement can disrupt the surgical site. Applying heat to the operative knee is not recommended immediately postoperatively as it can increase swelling and discomfort.

5. A nurse is teaching a client who has a new prescription for iron supplements. Which of the following statements by the client indicates an understanding of the teaching?

• A. I should take this medication with a glass of milk.
• B. I will take this medication with orange juice.
• C. I should expect my stools to be black and tarry.
• D. I will take this medication before bedtime.

Correct answer: C

Rationale: The correct answer is C. When a client understands the teaching about iron supplements, they should know that black, tarry stools are a normal side effect. This indicates that the medication is being absorbed and working effectively. Choices A and B are incorrect because iron supplements should not be taken with milk or orange juice, as these can interfere with the absorption of iron. Choice D is also incorrect because iron supplements are usually best absorbed on an empty stomach, so taking them before bedtime may not be ideal.

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