Nursing Elites

1. When administering digoxin (Lanoxin) to a patient, the healthcare provider observes various signs and symptoms of an overdose. Which of the following should the healthcare provider give to reverse digoxin toxicity?

• A. Naloxone
• B. Vitamin K
• C. Digibind
• D. Flumazenil

Correct answer: C

Rationale: Digibind, also known as Digoxin immune Fab, is the specific antidote used to treat digoxin toxicity. It works by binding to digoxin in the body, forming a complex that can be excreted by the kidneys, thereby reversing the toxic effects of digoxin overdose. Naloxone is used for opioid overdoses, not digoxin toxicity. Vitamin K is used to reverse the effects of warfarin overdose. Flumazenil is used to reverse the effects of benzodiazepine overdose, not digoxin toxicity.

2. A client is taking Digoxin and has a new prescription for Colesevelam. Which of the following instructions should the nurse include in the teaching?

• A. Take digoxin with your morning dose of colesevelam.
• B. Your sodium and potassium levels will be monitored periodically while taking colesevelam.
• C. Watch for bleeding or bruising while taking colesevelam.
• D. Take colesevelam with food and at least one glass of water.

Correct answer: D

Rationale: The correct instruction for taking Colesevelam is to take it with food and at least one glass of water. This helps to ensure proper absorption and reduce the risk of gastrointestinal side effects. Option A is incorrect because Digoxin and Colesevelam should not be taken together. Option B is irrelevant to the administration of Colesevelam. Option C is unrelated to the specific instructions for taking Colesevelam.

3. A healthcare professional reviewing a client's health record notes a new prescription for Lisinopril 10 mg PO once daily. The healthcare professional should identify this as which of the following types of prescription?

• A. Single
• B. Stat
• C. Routine
• D. Standing

Correct answer: C

Rationale: A routine prescription indicates that the medication is to be administered on a regular schedule, typically daily, without a specified termination date or a specific number of doses. In this case, Lisinopril 10 mg PO once daily is to be given regularly until the healthcare provider decides to discontinue it. This type of prescription is common for medications that are part of the client's ongoing treatment regimen. The other choices are incorrect: 'Single' does not provide information about the frequency or duration of administration, 'Stat' indicates an urgent, one-time administration, and 'Standing' refers to a prescription that is automatically renewed without the need for a new order for each administration.

4. When educating a client who has a prescription for Levothyroxine, which instruction should the nurse include?

• A. Take this medication on an empty stomach.
• B. Take this medication with food.
• C. Take this medication at bedtime.
• D. Take this medication with antacids.

Correct answer: A

Rationale: The correct instruction for taking Levothyroxine is on an empty stomach. This helps to enhance the absorption and effectiveness of the medication. Consuming it with food or antacids can impede its absorption, leading to decreased efficacy.

5. A client has a new prescription for Warfarin. The nurse should identify that the concurrent use of which of the following medications increases the client's risk of bleeding?

• A. Vitamin K
• B. Calcium carbonate
• C. Acetaminophen
• D. Ranitidine

Correct answer: C

Rationale: The correct answer is Acetaminophen (Choice C). Acetaminophen, especially in high doses, can increase the risk of bleeding in clients taking Warfarin. It can potentiate the anticoagulant effect of Warfarin, leading to an increased risk of bleeding. Vitamin K (Choice A) is actually used to reverse the effects of Warfarin in case of over-anticoagulation, so it does not increase the risk of bleeding. Calcium carbonate (Choice B) and Ranitidine (Choice D) do not significantly interact with Warfarin to increase the risk of bleeding.

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