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. What is the priority nursing assessment for a patient who has just returned from surgery?

• A. Monitor respiratory rate
• B. Monitor blood pressure
• C. Check the surgical site
• D. Monitor heart rate

Correct answer: A

Rationale: The correct answer is to monitor the patient's respiratory rate. This assessment is essential as it ensures that the patient is breathing adequately post-surgery. Maintaining a patent airway and adequate oxygenation are the top priorities in the immediate postoperative period. Monitoring blood pressure, checking the surgical site, or monitoring heart rate are important assessments but are not the priority immediately upon the patient's return from surgery.

3. Which electrolyte imbalance should be closely monitored in patients on diuretics?

• A. Hypokalemia
• B. Hyponatremia
• C. Hyperkalemia
• D. Hypercalcemia

Correct answer: A

Rationale: The correct answer is A: Hypokalemia. Patients on diuretics are at risk of developing hypokalemia due to increased potassium excretion by the kidneys. Hypokalemia can lead to serious consequences such as cardiac arrhythmias. Hyponatremia (choice B) is an imbalance of sodium levels and is not typically associated with diuretic use. Hyperkalemia (choice C) is the opposite condition where potassium levels are elevated and is less common in patients on diuretics. Hypercalcemia (choice D) is an excess of calcium in the blood and is not directly related to diuretic use. Therefore, monitoring for hypokalemia is crucial in patients taking diuretics.

4. A nurse is caring for a client who has a prescription for a low-sodium diet. Which of the following foods should the nurse recommend?

• A. Pickles
• B. Fresh vegetables
• C. Canned soup
• D. Smoked salmon

Correct answer: B

Rationale: Fresh vegetables are an excellent choice for clients on a low-sodium diet as they are naturally low in sodium. Pickles, canned soup, and smoked salmon are high in sodium and should be avoided by clients following a low-sodium diet. Pickles are pickled in a brine solution high in sodium, canned soup usually contains added salt for preservation, and smoked salmon is a processed food that typically has a high sodium content.

5. A client is receiving intermittent enteral tube feedings and is experiencing dumping syndrome. Which of the following actions should the nurse take?

• A. Administer a refrigerated feeding.
• B. Increase the amount of water used to flush the tubing.
• C. Decrease the rate of the client's feedings.
• D. Instruct the client to move onto their right side.

Correct answer: C

Rationale: Dumping syndrome is a condition that occurs when food moves too quickly from the stomach into the small intestine. Symptoms can include abdominal cramping, diarrhea, and sweating. To manage dumping syndrome in a client receiving enteral tube feedings, the nurse should decrease the rate of the feedings. This intervention helps slow down the movement of food through the gastrointestinal tract, reducing the symptoms. Administering a refrigerated feeding (choice A) or increasing the amount of water used to flush the tubing (choice B) are not appropriate actions for addressing dumping syndrome. Instructing the client to move onto their right side (choice D) is not a relevant intervention for managing dumping syndrome in this scenario.

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