Nursing Elites

1. When educating a client about the adverse effects of conjunctivitis, what is a serious condition that requires prompt attention?

• A. Contact lens irritation
• B. Decreased sex drive
• C. Brown spots on the skin
• D. Epigastric pain unrelieved by antacids

Correct answer: D

Rationale: Epigastric pain unrelieved by antacids is a concerning symptom that may indicate a more serious underlying condition such as a perforated ulcer. This symptom requires immediate medical attention to prevent further complications.

2. A client with chronic kidney disease is prescribed erythropoietin. The nurse should monitor for which potential adverse effect?

• A. Hypertension
• B. Hypotension
• C. Tachycardia
• D. Bradycardia

Correct answer: A

Rationale: Erythropoietin is a medication commonly used to stimulate red blood cell production in individuals with chronic kidney disease. One of the potential adverse effects of erythropoietin therapy is hypertension. The increased production of red blood cells can lead to elevated blood pressure levels. Therefore, monitoring for hypertension is essential to ensure the client's safety and well-being while on this medication. Choices B, C, and D are incorrect because hypotension, tachycardia, and bradycardia are not typically associated with erythropoietin therapy. Hypertension is the primary adverse effect to monitor in this case.

3. A practical nurse (PN) is preparing to administer enoxaparin to a client. What is the most important action for the PN to take before administering this medication?

• A. Assess the client's blood pressure.
• B. Check the client's platelet count.
• C. Monitor the client's urine output.
• D. Review the client's blood glucose level.

Correct answer: B

Rationale: The correct answer is to check the client's platelet count. Enoxaparin can lead to thrombocytopenia (low platelet count), which can increase the risk of bleeding. Therefore, assessing the platelet count before administering enoxaparin is crucial to ensure that it is within a safe range. Assessing the client's blood pressure (Choice A) is not directly related to enoxaparin administration. Monitoring urine output (Choice C) and reviewing blood glucose levels (Choice D) are not essential actions before administering enoxaparin.

4. An older adult with iron deficiency anemia is being discharged with iron supplements, which information should the nurse include in the discharge?

• A. Take the tablet with a daily multivitamin
• B. Crush the tablet and mix it with pudding
• C. Bedtime is the best time to take the tablet
• D. Wait 2 hours after meals to take the tablet

Correct answer: D

Rationale: The correct answer is to wait 2 hours after meals before taking the iron tablet. This is important to ensure better absorption and efficacy of the iron supplement. Taking the tablet with a daily multivitamin (Choice A) may interfere with iron absorption due to interactions with other minerals. Crushing the tablet and mixing it with pudding (Choice B) can alter the effectiveness of the medication. While bedtime (Choice C) may be convenient, waiting after meals is crucial for optimal iron absorption.

5. A 6-month-old infant is prescribed digoxin for the treatment of congestive heart failure. Which observation by the practical nurse (PN) warrants immediate intervention for signs of digoxin toxicity?

• A. Apical heart rate of 60 beats/min
• B. Sweating across the forehead
• C. Poor sucking effort
• D. Respiratory rate of 30 breaths/min

Correct answer: A

Rationale: A heart rate of 60 beats/min for a 6-month-old infant warrants immediate intervention as it falls below the normal range. The normal heart rate for a 6-month-old is 80 to 150 beats/min when awake, and a rate of 70 beats/min while sleeping is considered within normal limits. Bradycardia (heart rate <60 beats/min) in infants can be a sign of digoxin toxicity, necessitating prompt evaluation and intervention to prevent adverse effects. Sweating across the forehead (Choice B) is a non-specific symptom and may not directly indicate digoxin toxicity. Poor sucking effort (Choice C) and a respiratory rate of 30 breaths/min (Choice D) are not typically associated with digoxin toxicity and do not require immediate intervention in the context of this question.

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