Nursing Elites

1. A healthcare provider is teaching a client who has a new prescription for levothyroxine. Which of the following instructions should the healthcare provider include?

• A. Take this medication with meals.
• B. Take this medication at the same time every day.
• C. Report any chest pain to your healthcare provider immediately.
• D. Take an antacid if indigestion occurs.

Correct answer: B

Rationale: The correct instruction for a client prescribed levothyroxine is to take the medication at the same time every day. This consistency is important for maintaining stable thyroid hormone levels. Choice A is incorrect because levothyroxine should be taken on an empty stomach to ensure proper absorption. Choice C is important but not directly related to the administration of levothyroxine. Choice D is incorrect as antacids can interfere with the absorption of levothyroxine.

2. Which electrolyte imbalance is commonly seen in patients taking furosemide?

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

Correct answer: A

Rationale: The correct answer is A: Hypokalemia. Furosemide, a loop diuretic, can lead to potassium loss in the urine, resulting in hypokalemia. This electrolyte imbalance is commonly seen in patients taking furosemide and requires close monitoring. Choices B, C, and D are incorrect because furosemide does not typically cause hyponatremia, hyperkalemia, or hypercalcemia as frequently as it causes hypokalemia.

3. A client with heart failure is receiving digoxin. Which of the following findings should the nurse report to the provider?

• A. Heart rate of 78/min.
• B. Vision changes.
• C. Respiratory rate of 16/min.
• D. Blood pressure of 120/80 mm Hg.

Correct answer: B

Rationale: The correct answer is B: Vision changes. Vision changes are a classic sign of digoxin toxicity and should be reported immediately to the provider for further evaluation and management. A heart rate of 78/min, a respiratory rate of 16/min, and a blood pressure of 120/80 mm Hg are within normal ranges and are not typically associated with digoxin toxicity. Therefore, they would not be the priority findings to report in this situation.

4. A client has a new prescription for digoxin. Which of the following statements should the nurse include?

• A. You should take this medication on an empty stomach.
• B. You should avoid taking this medication with antacids.
• C. Take your pulse before taking this medication.
• D. You should contact your provider if you experience visual changes.

Correct answer: C

Rationale: The correct statement for the nurse to include when teaching a client about digoxin is to 'Take your pulse before taking this medication.' This is essential because clients taking digoxin need to monitor their pulse to detect signs of bradycardia, a common adverse effect of the medication. Option A is incorrect because digoxin is usually recommended to be taken with food to avoid gastrointestinal upset. Option B is incorrect because antacids can interfere with the absorption of digoxin. Option D is incorrect because contacting the provider for visual changes is important, but monitoring the pulse is crucial for digoxin administration.

5. A nurse is caring for a client who is 2 days postoperative following abdominal surgery. Which of the following findings should the nurse report to the provider?

• A. Serosanguineous wound drainage
• B. Heart rate of 90/min
• C. Urine output of 30 mL/hr
• D. Temperature of 37.3°C (99.1°F)

Correct answer: C

Rationale: A urine output of 30 mL/hr is significantly low and indicates possible renal impairment or inadequate perfusion to the kidneys, which are critical for postoperative recovery. In this situation, decreased urine output could lead to fluid and electrolyte imbalances, affecting the client's overall condition. The nurse should report this finding promptly to the healthcare provider for further evaluation and intervention. Serosanguineous wound drainage is a normal finding in the early postoperative period and does not typically warrant immediate concern. A heart rate of 90/min is within the normal range and may be expected in a postoperative client due to the stress response. A temperature of 37.3°C (99.1°F) is slightly elevated but not a concerning finding in isolation postoperatively.

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