Nursing Elites

1. A client with peptic ulcer disease is being taught about managing the disorder. Which of the following statements by the client indicates an understanding of the teaching?

• A. 'I should take NSAIDs for pain relief.'
• B. 'I should avoid drinking alcohol.'
• C. 'I should eat small, frequent meals.'
• D. 'I should drink milk to coat my stomach.'

Correct answer: B

Rationale: The correct answer is B. Avoiding alcohol is crucial in managing peptic ulcer disease as it helps prevent irritation and further damage to the stomach lining. Alcohol can worsen symptoms and hinder the healing process in individuals with this condition. Choice A is incorrect because NSAIDs can worsen peptic ulcers by irritating the stomach lining. Choice C is a correct dietary recommendation for managing peptic ulcer disease as it helps reduce stomach acid secretion and promotes healing. Choice D is incorrect as milk may temporarily soothe ulcer pain, but it can stimulate acid production and worsen symptoms in the long run.

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

• A. Take the medication with or without food.
• B. Monitor for signs of hypokalemia.
• C. Increase your intake of potassium-rich foods.
• D. Expect an increase in urination.

Correct answer: D

Rationale: The correct instruction to include when a client is prescribed furosemide is to expect an increase in urination. Furosemide is a diuretic that works by increasing urine production, so it is essential for the client to anticipate and understand this effect. Monitoring for signs of hypokalemia and increasing potassium-rich foods are not directly related to furosemide use. Hypokalemia is a potential side effect of furosemide, so monitoring for it is crucial. Increasing potassium-rich foods can help counteract potassium loss due to diuretic use. Taking furosemide with food is not required, as it can be taken with or without food.

3. The client is taking interferon alfa-2a (Roferon-A) and ribavirin (Virazole) combination therapy for hepatitis C and reports overwhelming feelings of depression. Which action should the nurse implement first?

• A. Recommend mental health counseling.
• B. Review the medication actions and interactions.
• C. Assess the client's daily activity level.
• D. Provide information about a support group.

Correct answer: B

Rationale: The priority action for the nurse is to review the medication actions and interactions. Interferon alfa-2a and ribavirin combination therapy for hepatitis C can lead to neuropsychiatric side effects, including depression. By assessing the medication actions and interactions, the nurse can identify if the depression is a known side effect of the medications, and further intervention or adjustment of the treatment plan may be required to address the client's emotional well-being. Recommending mental health counseling (choice A) may be necessary but should come after ensuring that the depression is not solely caused by medication side effects. Assessing the client's daily activity level (choice C) and providing information about a support group (choice D) are important interventions but addressing the medication's potential contribution to the depression takes precedence.

4. A client with deep vein thrombosis (DVT) is receiving anticoagulant therapy. The nurse should reinforce with the client the importance of reporting which potential side effect?

• A. Nausea
• B. Headache
• C. Gingival bleeding
• D. Dizziness

Correct answer: C

Rationale: The correct answer is C, 'Gingival bleeding.' Gingival bleeding is a common side effect of anticoagulant therapy. Anticoagulants work by prolonging the time it takes for blood to clot, which can lead to bleeding issues, including gingival bleeding. Nausea, headache, and dizziness are not typically associated with anticoagulant therapy. Since bleeding, including gingival bleeding, can be a serious side effect that requires medical attention, the client should be educated on reporting it promptly to their healthcare provider.

5. A client with heart failure is receiving digoxin. Which finding should indicate to the nurse that the client is experiencing digoxin toxicity?

• A. Constipation
• B. Blurred vision
• C. Bradycardia
• D. Dry cough

Correct answer: C

Rationale: Bradycardia is a hallmark sign of digoxin toxicity. Digoxin, a medication used to treat heart conditions, can lead to toxicity manifesting as bradycardia. Bradycardia occurs due to the drug's effect on slowing down the heart rate excessively. Constipation (Choice A) is not typically associated with digoxin toxicity. Blurred vision (Choice B) is more commonly linked to visual disturbances caused by digoxin, but it is not a defining sign of toxicity. Dry cough (Choice D) is not a recognized symptom of digoxin toxicity. It is crucial for the nurse to recognize the early signs of digoxin toxicity to prevent serious complications and provide appropriate interventions promptly.

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