Nursing Elites

1. The LPN/LVN is assisting in the care of a client with a diagnosis of heart failure who is receiving digoxin (Lanoxin). Which laboratory result should the nurse monitor closely?

• A. Serum sodium
• B. Serum potassium
• C. Serum calcium
• D. Serum glucose

Correct answer: B

Rationale: The correct answer is serum potassium. Monitoring serum potassium levels is crucial when a client is receiving digoxin (Lanoxin) because low potassium levels can increase the risk of digoxin toxicity. Digoxin and low potassium levels can lead to serious cardiac complications, such as arrhythmias. Therefore, close monitoring of serum potassium is essential to prevent adverse effects and ensure the safe administration of digoxin in clients with heart failure. Serum sodium, serum calcium, and serum glucose levels are also important laboratory values to monitor in clients with heart failure, but they are not directly associated with the risk of digoxin toxicity. Monitoring these values helps in assessing overall health status, fluid balance, and metabolic functions in the client.

2. The nurse is assisting with the care of a client who is on a continuous heparin infusion for deep vein thrombosis (DVT). Which laboratory test should the nurse monitor to evaluate the effectiveness of the therapy?

• A. Prothrombin time (PT)
• B. Activated partial thromboplastin time (aPTT)
• C. International normalized ratio (INR)
• D. Platelet count

Correct answer: B

Rationale: To evaluate the effectiveness of heparin therapy in a client with DVT, the nurse should monitor the activated partial thromboplastin time (aPTT). The aPTT test helps ensure that the dose of heparin is within the therapeutic range, which is essential for preventing clot formation or excessive bleeding. Monitoring aPTT is crucial in managing patients on heparin therapy to maintain the delicate balance between preventing thrombosis and avoiding hemorrhage. Prothrombin time (PT) and International normalized ratio (INR) are more indicative of warfarin therapy effectiveness, not heparin. Platelet count assesses platelet levels and function, not the effectiveness of heparin therapy for DVT.

3. The nurse is preparing to administer an intravenous dose of furosemide (Lasix) to a client with heart failure. The nurse should monitor for which potential side effect?

• A. Hypertension
• B. Hyperkalemia
• C. Hypokalemia
• D. Hypoglycemia

Correct answer: C

Rationale: Furosemide is a loop diuretic that works by promoting the excretion of water and electrolytes, including potassium. This loss of potassium can lead to hypokalemia, which can be a potential side effect of furosemide administration. Hypokalemia can result in cardiac dysrhythmias and other complications, especially in clients with heart failure who may already have compromised cardiac function. Therefore, monitoring for signs of hypokalemia, such as muscle weakness, cardiac irregularities, and fatigue, is essential when administering furosemide. Choice A, hypertension, is incorrect because furosemide is actually used to treat hypertension by reducing excess fluid in the body. Choice B, hyperkalemia, is incorrect as furosemide causes potassium loss, leading to hypokalemia. Choice D, hypoglycemia, is unrelated to the mechanism of action of furosemide and is not a common side effect associated with its administration.

4. A nurse is assessing a client who has a new prescription for enalapril. Which of the following findings is a priority for the nurse to report to the provider?

• A. Frequent urination
• B. Dry cough
• C. Tremors
• D. Dizziness

Correct answer: D

Rationale: The correct answer is D: Dizziness. Dizziness is a sign of hypotension, a potential adverse effect of enalapril. Enalapril is an ACE inhibitor commonly prescribed for hypertension. Hypotension is a serious side effect that can lead to complications such as falls and injuries. Reporting dizziness promptly is crucial to prevent any harm to the client. Choices A, B, and C are not directly associated with enalapril use and are less concerning compared to the potential implications of hypotension indicated by dizziness.

5. When teaching a client about the use of lisinopril, which of the following instructions should the nurse include?

• A. Monitor your blood pressure regularly.
• B. Take the medication with food.
• C. Increase your intake of potassium-rich foods.
• D. Avoid grapefruit juice.

Correct answer: A

Rationale: The correct answer is to instruct the client to monitor their blood pressure regularly when taking lisinopril. Lisinopril is known to cause hypotension, so monitoring blood pressure is crucial to ensure it stays within a safe range. This monitoring helps in early detection of any potential issues related to low blood pressure, allowing for timely intervention. Choices B, C, and D are incorrect because taking lisinopril with food, increasing potassium-rich foods intake, and avoiding grapefruit juice are not specific instructions related to the safe and effective use of lisinopril.

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