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. A client with a history of angina is scheduled for an exercise electrocardiography (ECG) test. The nurse should explain that the purpose of this test is to evaluate which factor?

• A. The heart's response to physical stress
• B. The client's overall physical fitness
• C. The presence of electrolyte imbalances
• D. The effectiveness of anti-anginal medications

Correct answer: A

Rationale: An exercise electrocardiography (ECG) test is used to evaluate the heart's response to physical stress. During the test, the heart's electrical activity is monitored while the client exercises, helping to identify any areas of ischemia or abnormal rhythms. This test helps healthcare providers assess the heart's function and detect any potential issues related to angina or other cardiac conditions. Choice B, the client's overall physical fitness, is incorrect because the test primarily focuses on the heart's response to stress rather than the client's general physical fitness. Choice C, the presence of electrolyte imbalances, is incorrect as this test is not specifically designed to evaluate electrolyte levels. Choice D, the effectiveness of anti-anginal medications, is incorrect as the main purpose of the test is to assess the heart's response to physical stress, not medication effectiveness.

3. A client with a history of coronary artery disease (CAD) is prescribed atorvastatin (Lipitor). The nurse should teach the client about which common side effect of this medication?

• A. Dry mouth
• B. Muscle pain
• C. Drowsiness
• D. Diarrhea

Correct answer: B

Rationale: Muscle pain is a common side effect of statins like atorvastatin. It is important for the nurse to educate the client about this potential side effect, as it can indicate a serious condition called rhabdomyolysis, which requires immediate medical attention. Dry mouth, drowsiness, and diarrhea are not typically associated with atorvastatin use.

4. 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.

5. A client is admitted to the hospital with a diagnosis of pericarditis. The nurse reviews the client's record for which sign or symptom that differentiates pericarditis from other cardiopulmonary problems?

• A. Anterior chest pain
• B. Pericardial friction rub
• C. Weakness and irritability
• D. Chest pain that worsens with inspiration

Correct answer: B

Rationale: Pericardial friction rub is a distinctive sign of pericarditis, characterized by a scraping or grating sound heard on auscultation, which helps differentiate pericarditis from other cardiopulmonary conditions. While anterior chest pain may be present in various cardiopulmonary issues, it is not specific to pericarditis. Weakness and irritability are nonspecific symptoms that can be seen in many conditions. Chest pain worsening with inspiration is more indicative of pleuritic conditions such as pleurisy or pneumonia, rather than pericarditis.

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