Nursing Elites

1. A client is being educated by a healthcare provider about managing Digoxin toxicity. Which statement by the client demonstrates an understanding of the teaching?

• A. I will take an extra dose of Digoxin if I miss one.
• B. I should notify my healthcare provider if I experience visual changes.
• C. I will stop taking Digoxin if my heart rate is below 70 bpm.
• D. I should take antacids to alleviate gastrointestinal upset.

Correct answer: B

Rationale: The correct answer is B. Visual changes, such as yellow or blurred vision, can be indicative of digoxin toxicity. It is crucial for clients to inform their healthcare provider promptly if they encounter these symptoms. Prompt medical attention can help manage potential toxicity and prevent complications. Choices A, C, and D are incorrect because taking an extra dose of Digoxin, stopping Digoxin based on heart rate alone, and using antacids for gastrointestinal upset are not appropriate actions when managing Digoxin toxicity.

2. An older adult client has a new prescription for Digoxin and takes multiple other medications. The nurse should recognize that concurrent use of which of the following medications places the client at risk for Digoxin toxicity?

• A. Phenytoin
• B. Verapamil
• C. Warfarin
• D. Aluminum hydroxide

Correct answer: B

Rationale: Verapamil, a calcium-channel blocker, can increase digoxin levels, leading to toxicity. When given together, the digoxin dosage may need adjustment, and the nurse should closely monitor the client's digoxin levels to prevent toxicity symptoms such as nausea, vomiting, visual disturbances, and arrhythmias. The other choices, Phenytoin, Warfarin, and Aluminum hydroxide, do not significantly interact with Digoxin to cause toxicity. Phenytoin may reduce Digoxin levels, while Warfarin and Aluminum hydroxide have minimal interactions with Digoxin.

3. A client informs a healthcare professional about taking Gingko Biloba. Which of the following medications is contraindicated for a client using Gingko Biloba?

• A. Acetaminophen
• B. Warfarin
• C. Digoxin
• D. Lisinopril

Correct answer: B

Rationale: Warfarin is contraindicated for a client taking Gingko Biloba due to the potential interaction that can lead to suppressed coagulation and an increased risk of bleeding or hemorrhage. Warfarin is an anticoagulant, and when combined with Gingko Biloba, which also has anticoagulant properties, the risk of bleeding complications is significantly heightened. Acetaminophen (Choice A), Digoxin (Choice C), and Lisinopril (Choice D) do not have significant interactions with Gingko Biloba compared to Warfarin. Acetaminophen is a pain reliever, Digoxin is a medication for heart conditions, and Lisinopril is an ACE inhibitor for hypertension.

4. During transfusion of a unit of whole blood, a nurse is assessing a client who develops a cough, shortness of breath, elevated blood pressure, and distended neck veins. The nurse should anticipate a prescription for which of the following medications?

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

Correct answer: C

Rationale: The client's symptoms indicate circulatory overload, which can occur during blood transfusions. Furosemide, a loop diuretic, is commonly prescribed in such cases to help relieve manifestations of circulatory overload by promoting diuresis and reducing fluid volume. Epinephrine is used for severe allergic reactions, lorazepam for anxiety or seizures, and diphenhydramine for mild allergic reactions or as a sedative. Therefore, the correct choice is Furosemide (C) to manage circulatory overload during a blood transfusion.

5. A client with asthma has a new prescription for inhaled beclomethasone. Which of the following instructions should the nurse provide?

• A. Check the pulse after using the inhaler.
• B. Take the medication with food.
• C. Rinse the mouth after using the inhaler.
• D. Reduce caffeine consumption.

Correct answer: C

Rationale: The correct answer is C: 'Rinse the mouth after using the inhaler.' Rinsing the mouth after using inhaled beclomethasone is crucial to prevent fungal overgrowth in the mouth, a common side effect of corticosteroid inhalers. Checking the pulse after using the inhaler (Choice A) is not directly related to the use of beclomethasone. Taking the medication with food (Choice B) is not a specific instruction for inhaled beclomethasone. While reducing caffeine consumption (Choice D) can be beneficial for some health conditions, it is not a specific instruction related to using inhaled beclomethasone.

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