Nursing Elites

1. A client has a new prescription for Digoxin to treat heart failure. Which of the following instructions should the nurse include in the teaching?

• A. Contact the provider if the heart rate is less than 60/min.
• B. Check the pulse rate for 30 seconds and multiply the result by 2.
• C. Increase the intake of sodium.
• D. Take with food if nausea occurs.

Correct answer: A

Rationale: The correct answer is A. It is crucial for clients on Digoxin to monitor their heart rate. A heart rate less than 60/min can indicate bradycardia, a potential side effect of Digoxin. Therefore, the client should be instructed to contact the provider if their heart rate is less than 60/min to prevent complications and receive appropriate management. Choices B, C, and D are incorrect. Checking the pulse rate for 30 seconds and multiplying by 2 is not specific to Digoxin administration. Increasing sodium intake is contraindicated as Digoxin can lead to sodium retention. Taking Digoxin with food if nausea occurs is not recommended as it may affect the drug's absorption.

2. Which of the following conditions is not treated with Dexamethasone?

• A. Inflammation
• B. Asthma
• C. Addison’s disease
• D. Wilson’s disease

Correct answer: D

Rationale: Dexamethasone is not used to treat Wilson’s disease. It is a corticosteroid primarily used for conditions like inflammation, asthma, and Addison’s disease. Wilson’s disease is a genetic disorder involving copper accumulation and is treated with medications like chelating agents or zinc salts, not Dexamethasone.

3. During a unit of whole blood transfusion, a client develops a cough, shortness of breath, elevated blood pressure, and distended neck veins. The healthcare professional should anticipate a prescription for which of the following medications?

• A. Epinephrine
• B. Lorazepam
• C. Furosemide
• D. Diphenhydramine

Correct answer: C

Rationale: In the scenario described, the client is exhibiting signs of fluid overload, which can occur during blood transfusion. Furosemide, a loop diuretic, is commonly prescribed in such situations to help relieve manifestations of circulatory overload by promoting diuresis and reducing fluid volume. Therefore, the correct choice is C - Furosemide. Epinephrine (Choice A) is not indicated for fluid overload but for severe allergic reactions. Lorazepam (Choice B) is a benzodiazepine used for anxiety or sedation, not for fluid overload. Diphenhydramine (Choice D) is an antihistamine often used for allergic reactions, not for fluid overload.

4. A client has Diabetes Mellitus, Pulmonary Tuberculosis, and a new prescription for Isoniazid. Which of the following supplements should the nurse expect to administer to prevent an adverse effect of INH?

• A. Ascorbic acid
• B. Pyridoxine
• C. Folic acid
• D. Cyanocobalamin

Correct answer: B

Rationale: Pyridoxine is administered with Isoniazid to prevent peripheral neuropathy, a common adverse effect of the drug. It is essential to provide this supplement to the client to minimize the risk of developing this adverse effect. Ascorbic acid (Vitamin C) is not typically given to prevent INH adverse effects. Folic acid and Cyanocobalamin are not commonly administered with INH for this purpose.

5. Which adverse reaction poses the greatest life-threatening risk when taking Omeprazole?

• A. Chest pain
• B. Constipation
• C. Clostridium difficile-associated diarrhea
• D. Acute interstitial nephritis

Correct answer: C

Rationale: The most life-threatening adverse reaction associated with Omeprazole is Clostridium difficile-associated diarrhea. This condition can be severe and life-threatening due to the potential for dehydration, electrolyte imbalances, and complications such as toxic megacolon. Chest pain, constipation, and acute interstitial nephritis are potential side effects of Omeprazole but are not considered as life-threatening as Clostridium difficile-associated diarrhea. Monitoring for signs of this adverse reaction is crucial, and immediate medical attention should be sought if symptoms develop.

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