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 receiving Gentamicin. Which of the following laboratory values should the nurse monitor to assess for nephrotoxicity?

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

Correct answer: B

Rationale: When a client is receiving Gentamicin, the nurse should monitor serum creatinine levels to assess for nephrotoxicity. Gentamicin is known to potentially cause nephrotoxicity, leading to impaired kidney function. Monitoring serum creatinine levels helps in early detection of any kidney damage or dysfunction. Serum sodium, serum potassium, and serum glucose levels are not directly related to nephrotoxicity caused by Gentamicin, so they are not the appropriate values to monitor in this case.

3. A client is receiving discharge instructions for long-term use of Prednisone. Which of the following instructions should be included?

• A. Stop taking the medication if you experience swelling.
• B. The provider will monitor your weight regularly.
• C. Take the medication on an empty stomach.
• D. You may notice decreased appetite while on this medication.

Correct answer: B

Rationale: The correct answer is B because long-term use of Prednisone can lead to weight gain, necessitating regular weight monitoring by the healthcare provider to manage any potential complications. Prednisone often causes fluid retention, leading to weight gain, hence the need for weight monitoring. Options A, C, and D are incorrect because swelling is not a typical reason to stop Prednisone, taking it on an empty stomach is not usually required, and Prednisone commonly increases appetite rather than decreases it.

4. A client has a new prescription for Lovastatin. Which of the following instructions should be included?

• A. Take this medication on an empty stomach.
• B. Take this medication in the morning.
• C. Take this medication at bedtime.
• D. Increase your intake of potassium-rich foods.

Correct answer: C

Rationale: Lovastatin should be taken at bedtime because cholesterol production in the liver is highest at night, making the medication more effective in reducing cholesterol levels. By taking it at bedtime, the medication aligns with the body's natural rhythm of cholesterol synthesis, optimizing its therapeutic effects.

5. A client is receiving treatment with methotrexate. Which of the following supplements should the nurse instruct the client to take?

• A. Folic acid
• B. Vitamin D
• C. Calcium
• D. Iron

Correct answer: A

Rationale: The nurse should instruct the client to take folic acid when receiving treatment with methotrexate to reduce the risk of methotrexate toxicity. Methotrexate acts as a folic acid antagonist, leading to folic acid deficiency, which can be counteracted by supplementing with folic acid. Vitamin D, calcium, and iron are not specifically recommended to counteract methotrexate effects and do not play a significant role in mitigating methotrexate toxicity.

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