Nursing Elites

1. A client has a new prescription for Digoxin. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Monitor your pulse before taking the medication.
• C. Expect to have an increased appetite.
• D. Discontinue the medication if you feel nauseated.

Correct answer: B

Rationale: When educating a client about Digoxin, it is crucial to instruct them to monitor their pulse before taking the medication. Digoxin can lead to bradycardia, so monitoring the pulse is essential to ensure it is not below 60 beats per minute before taking each dose. If the pulse is low, the client should hold the dose and seek guidance from their healthcare provider. Choices A, C, and D are incorrect. Taking Digoxin with food may affect its absorption, Digoxin is not known to increase appetite, and feeling nauseated does not necessarily indicate the need to discontinue the medication.

2. A client has a new prescription for Warfarin. Which of the following statements should the nurse include in the teaching?

• A. You will need to have your blood tested regularly while taking this medication.
• B. It is safe to take over-the-counter NSAIDs with this medication.
• C. You will need to avoid foods high in vitamin K while taking this medication.
• D. You will need to take this medication with food.

Correct answer: C

Rationale: Warfarin interacts with vitamin K, so clients should be instructed to avoid foods high in vitamin K. This is because vitamin K can interfere with the anticoagulant effects of Warfarin. It is important to maintain a consistent intake of vitamin K-containing foods to keep the medication working effectively. Therefore, the correct statement for the nurse to include in the teaching is to advise the client to avoid foods high in vitamin K while taking Warfarin. Choices A, B, and D are incorrect. Regular blood testing is necessary with Warfarin to monitor its effects and adjust the dosage if needed (Choice A). Taking over-the-counter NSAIDs with Warfarin is not safe due to an increased risk of bleeding (Choice B). Warfarin can be taken with or without food, so there is no specific requirement to take it with food (Choice D).

3. A client is receiving combination chemotherapy. Which of the following findings should the nurse identify as an indication of an oncologic emergency?

• A. Dry oral mucous membranes
• B. Nausea and vomiting
• C. Temperature of 38.1°C (100.6°F)
• D. Anorexia

Correct answer: C

Rationale: A temperature of 38.1°C (100.6°F) can indicate an infection, which is considered an oncologic emergency in clients receiving chemotherapy due to the increased risk of sepsis in immunocompromised individuals. Dry oral mucous membranes (Choice A), nausea and vomiting (Choice B), and anorexia (Choice D) are common side effects of chemotherapy but do not typically indicate an oncologic emergency requiring immediate intervention.

4. A client is prescribed Amlodipine. Which of the following adverse effects should the nurse monitor?

• A. Tachycardia
• B. Peripheral edema
• C. Hyperglycemia
• D. Hypertension

Correct answer: B

Rationale: Corrected Rationale: Amlodipine is a calcium channel blocker known to cause peripheral edema as an adverse effect. The nurse should monitor the client for swelling, particularly in the lower extremities, as it can indicate the development of this side effect. Choice A, Tachycardia, is not a common adverse effect of Amlodipine. Choice C, Hyperglycemia, is not typically associated with Amlodipine use. Choice D, Hypertension, is the condition Amlodipine is prescribed to treat, not an adverse effect of the medication.

5. Which drug class has been found to decrease mortality if given within 8 hours of an MI due to a decrease in cardiac workload?

• A. Antiplatelets
• B. Beta-adrenergic blockers
• C. ACE inhibitors
• D. Calcium channel blockers

Correct answer: B

Rationale: Beta-adrenergic blockers have been shown to decrease mortality when administered within 8 hours of a myocardial infarction (MI). They do so by reducing cardiac workload, which helps improve outcomes post-MI. These drugs work by blocking the effects of adrenaline on the heart, leading to decreased heart rate, blood pressure, and myocardial oxygen demand, thereby protecting the heart muscle from further damage. This makes them a crucial part of the treatment regimen for acute coronary syndromes like MI.

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