Nursing Elites

1. A healthcare professional is reviewing the medication list of a client who has a new prescription for Digoxin to treat heart failure. Which of the following medications places the client at risk for Digoxin toxicity?

• A. Spironolactone
• B. Calcium channel blockers
• C. Loop diuretics
• D. ACE inhibitors

Correct answer: C

Rationale: Loop diuretics, such as Furosemide, can increase the risk of Digoxin toxicity by causing hypokalemia. Hypokalemia enhances the toxic effects of Digoxin on the heart, leading to an increased risk of Digoxin toxicity. Spironolactone (Choice A) is less likely to cause hypokalemia and does not significantly increase the risk of Digoxin toxicity. Calcium channel blockers (Choice B) and ACE inhibitors (Choice D) do not directly increase the risk of Digoxin toxicity through hypokalemia; therefore, they are not the medications that place the client at risk for Digoxin toxicity.

2. A client is starting therapy with topotecan. Which of the following findings should the nurse instruct the client to report?

• A. Hair loss
• B. Fatigue
• C. Sore throat
• D. Red urine

Correct answer: C

Rationale: The nurse should instruct the client to report a sore throat because it can indicate an infection due to the immunosuppressive effects of topotecan. Monitoring for signs of infection is crucial to prevent complications during therapy. Choices A, B, and D are less critical findings compared to a sore throat. Hair loss is a common side effect of chemotherapy, fatigue is expected with cancer treatment, and red urine is a known harmless effect of topotecan.

3. A client has a prescription for Trimethoprim-Sulfamethoxazole. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Increase fluid intake.
• C. Expect reddish-orange urine.
• D. Avoid high-protein foods.

Correct answer: B

Rationale: The correct instruction for a client prescribed Trimethoprim-Sulfamethoxazole is to increase fluid intake. This helps prevent crystalluria and kidney stones, which are potential adverse effects of this medication. Adequate hydration is essential to reduce the risk of these complications.

4. What is the classification for the drug valproate?

• A. Anti-diabetic
• B. Anti-convulsant
• C. Anti-ulcer agent
• D. Anti-hypertensive

Correct answer: B

Rationale: Valproate is classified as an anticonvulsant. It is commonly used to treat epilepsy and bipolar disorder by stabilizing electrical activity in the brain. Therefore, the correct classification for valproate is as an anticonvulsant. Options A, C, and D are incorrect because valproate is not used to treat diabetes, ulcers, or hypertension.

5. A client reports taking Aspirin four times daily for a sprained wrist. Which of the following prescribed medications taken by the client is contraindicated with aspirin?

• A. Digoxin
• B. Metformin
• C. Warfarin
• D. Nitroglycerin

Correct answer: C

Rationale: Aspirin inhibits platelet aggregation, which can increase the effect of anticoagulants like warfarin, leading to an elevated risk of bleeding. Therefore, the concurrent use of aspirin and warfarin is generally contraindicated due to this potential interaction. Digoxin is not contraindicated with aspirin in most cases. Metformin and nitroglycerin do not have significant interactions with aspirin, making them less likely to be contraindicated in this scenario.

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