Nursing Elites

1. The nurse is caring for a client with heart failure who is receiving digoxin (Lanoxin). Which sign of digoxin toxicity should the nurse monitor for?

• A. Hypertension
• B. Bradycardia
• C. Hyperglycemia
• D. Insomnia

Correct answer: B

Rationale: Corrected Rationale: Bradycardia is a common sign of digoxin toxicity. Digoxin can cause bradycardia due to its effects on the heart's electrical conduction system. Monitoring for a slow heart rate is crucial as it indicates potential toxicity. Hypertension, hyperglycemia, and insomnia are not typically associated with digoxin toxicity. Hypertension is more commonly seen in other conditions, hyperglycemia is not a typical sign of digoxin toxicity, and insomnia is not a recognized symptom of digoxin toxicity.

2. The healthcare provider is reinforcing dietary instructions to a client with coronary artery disease who has been prescribed a low-cholesterol diet. The healthcare provider should advise the client to choose which food item?

• A. Whole milk
• B. Oatmeal with fresh fruit
• C. Fried chicken
• D. Bacon and eggs

Correct answer: B

Rationale: Oatmeal with fresh fruit is the correct choice for a client with coronary artery disease on a low-cholesterol diet. Oatmeal is a heart-healthy option that is low in cholesterol and saturated fats. Fresh fruits are also a good source of essential nutrients and fiber. Choices A, C, and D are not suitable for a low-cholesterol diet. Whole milk, fried chicken, bacon, and eggs are high in cholesterol and saturated fats, which can be detrimental to individuals with coronary artery disease.

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

• A. Take the medication with food.
• B. Monitor for signs of hyperglycemia.
• C. Increase your fluid intake.
• D. Expect a sweet taste in your mouth.

Correct answer: C

Rationale: The correct instruction for a client starting metformin is to increase fluid intake. Metformin commonly causes gastrointestinal discomfort, and increasing fluid intake can help alleviate this side effect. Instructing the client to take the medication with food (Choice A) rather than on an empty stomach is recommended to reduce gastrointestinal side effects. Monitoring for signs of hyperglycemia (Choice B) is not directly related to metformin but rather to low blood sugar. Expecting a sweet taste in the mouth (Choice D) is not a common side effect of metformin.

4. The LPN/LVN is assisting in the care of a client with chronic heart failure who is receiving digoxin (Lanoxin). Which sign should the nurse monitor for that could indicate digoxin toxicity?

• A. Bradycardia
• B. Tachycardia
• C. Hypertension
• D. Hyperglycemia

Correct answer: A

Rationale: Bradycardia is a common sign of digoxin toxicity and should be closely monitored. Digoxin toxicity can lead to various cardiac dysrhythmias, with bradycardia being a significant indicator. Monitoring the client's heart rate is crucial to detect and manage digoxin toxicity promptly. Tachycardia, hypertension, and hyperglycemia are not typically associated with digoxin toxicity. Tachycardia is more commonly seen with inadequate treatment of heart failure, hypertension is a possible but less common effect, and hyperglycemia is not a typical sign of digoxin toxicity.

5. The client has been prescribed atorvastatin (Lipitor) for hyperlipidemia. Which instruction should the nurse provide to the client?

• A. Take the medication in the morning with breakfast.
• B. Avoid drinking grapefruit juice while taking this medication.
• C. Increase your intake of dietary fiber while on this medication.
• D. Avoid eating foods high in potassium.

Correct answer: B

Rationale: The correct instruction for the nurse to provide to the client prescribed atorvastatin (Lipitor) for hyperlipidemia is to avoid drinking grapefruit juice while taking this medication. Grapefruit juice can interfere with the metabolism of atorvastatin, leading to an increased risk of side effects. It is crucial for the client to adhere to this instruction to ensure the effectiveness and safety of the treatment. Choices A, C, and D are incorrect because taking the medication with breakfast, increasing dietary fiber intake, and avoiding foods high in potassium are not specific instructions related to atorvastatin therapy for hyperlipidemia.

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