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. Which of the following drugs is associated with Stevens-Johnson syndrome?

• A. Valproic acid
• B. Quinidine
• C. Isoniazid
• D. Ethosuximide

Correct answer: D

Rationale: Stevens-Johnson syndrome is a severe skin reaction that can be associated with Ethosuximide.

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

• A. Apply the patch to a different site each day.
• B. Remove the patch at bedtime each day.
• C. Apply the patch over an area with little or no hair.
• D. Keep the patch on for 24 hours at a time.

Correct answer: B

Rationale: The correct instruction for a client using a Nitroglycerin transdermal patch is to remove the patch each day, usually at bedtime, to prevent tolerance. This practice allows for a nitrate-free interval, reducing the risk of developing tolerance to the medication. Applying the patch to a different site each day (choice A) is not necessary as long as the skin is clean and rotated to avoid skin irritation. Applying the patch over an area with little or no hair (choice C) does not impact the effectiveness of the medication. Keeping the patch on for 24 hours at a time (choice D) can lead to tolerance, which is why the patch should be removed daily.

4. A client is starting therapy with cisplatin, and a healthcare provider is providing education. Which of the following findings should the healthcare provider instruct the client to report?

• A. Tinnitus
• B. Nausea
• C. Constipation
• D. Weight gain

Correct answer: A

Rationale: The correct answer is A: Tinnitus. The healthcare provider should instruct the client to report tinnitus, as it can be an indication of ototoxicity, an adverse effect associated with cisplatin therapy. Ototoxicity is damage to the inner ear structures that can lead to hearing loss, making it crucial for the client to report any early signs such as tinnitus to prevent further complications. Choices B, C, and D are less concerning in the context of cisplatin therapy. Nausea and constipation are common side effects of cisplatin but are not typically indicative of serious complications requiring immediate reporting. Weight gain is not a typical side effect associated with cisplatin therapy and is less likely to be related to the medication.

5. A healthcare provider is caring for a 4-year-old child who is resistant to taking medication. Which of the following strategies should the healthcare provider use to elicit the child's cooperation?

• A. Offer the child a choice of taking the medication with juice or water
• B. Tell the child it is candy
• C. Hide the medication in a large dish of ice cream
• D. Tell the child they will have a shot instead

Correct answer: A

Rationale: Offering children choices empowers them and can help in gaining cooperation, especially when it comes to taking medications. By providing options like taking the medication with juice or water, the child feels a sense of control and may be more willing to cooperate. This approach respects the child's autonomy and can make the experience more positive for both the child and the healthcare provider. Choices B, C, and D are not ideal strategies as they involve deception or coercion, which can lead to distrust and make the child more resistant to taking medication in the future.

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