Nursing Elites

1. Which electrolyte imbalance is most concerning in a patient taking digoxin?

• A. Monitor potassium levels
• B. Monitor calcium levels
• C. Monitor sodium levels
• D. Monitor magnesium levels

Correct answer: A

Rationale: The correct answer is to monitor potassium levels. Patients taking digoxin are at risk of developing toxicity due to hypokalemia. Low potassium levels can potentiate the toxic effects of digoxin on the heart, leading to serious arrhythmias. Monitoring calcium levels (Choice B) is not the primary concern in patients taking digoxin. While calcium levels play a role in cardiac function, hypocalcemia is not directly associated with digoxin toxicity. Monitoring sodium levels (Choice C) is important for other conditions but is not the primary concern in a patient taking digoxin. Monitoring magnesium levels (Choice D) is also essential, but hypomagnesemia is not as directly linked to digoxin toxicity as hypokalemia.

2. A client who has a new prescription for prednisone is being discharged. Which of the following client statements indicates an understanding of the teaching?

• A. I should take this medication with food.
• B. I will need to take this medication for the rest of my life.
• C. I should avoid crowded places while taking this medication.
• D. I will take this medication until my symptoms resolve.

Correct answer: C

Rationale: The correct answer is C. Clients taking prednisone should avoid crowded places to reduce the risk of infection due to immunosuppression. Choice A is incorrect because prednisone should be taken with food to reduce stomach upset. Choice B is incorrect as prednisone is usually prescribed for a specific duration and not for life. Choice D is incorrect because prednisone should be taken as prescribed by the healthcare provider, which may not always align with symptom resolution.

3. A nurse is caring for a client who is experiencing acute alcohol withdrawal. Which of the following actions should the nurse take?

• A. Administer haloperidol as prescribed.
• B. Keep the client in a supine position.
• C. Administer lorazepam as prescribed.
• D. Encourage the client to drink fluids with meals.

Correct answer: C

Rationale: The correct action the nurse should take when caring for a client experiencing acute alcohol withdrawal is to administer lorazepam as prescribed. Lorazepam is a benzodiazepine used to prevent seizures and manage agitation in clients undergoing alcohol withdrawal. Administering haloperidol (Choice A) is not recommended in alcohol withdrawal as it may lower the seizure threshold. Keeping the client in a supine position (Choice B) is not specifically indicated in managing alcohol withdrawal. Encouraging the client to drink fluids with meals (Choice D) is important for hydration but does not address the acute symptoms of alcohol withdrawal.

4. A client with a new colostomy requires care planning by a nurse. Which of the following interventions should the nurse include in the plan of care?

• A. Change the ostomy pouch every 4 to 7 days.
• B. Empty the ostomy pouch when it is half full.
• C. Apply a skin barrier around the stoma.
• D. Cleanse the peristomal skin with alcohol.

Correct answer: A

Rationale: The correct answer is to change the ostomy pouch every 4 to 7 days. This practice helps prevent skin irritation and leakage by maintaining a clean and secure seal around the stoma. Option B is incorrect because it is more important to change the pouch regularly rather than emptying it when half full. Option C is incorrect as applying a skin barrier is typically done during the initial application of the pouch, not during regular changes. Option D is incorrect because alcohol can be too harsh for the peristomal skin and can cause irritation.

5. A nurse is caring for a client who has cirrhosis. Which of the following laboratory values should the nurse expect to be decreased?

• A. Bilirubin.
• B. Albumin.
• C. Ammonia.
• D. Prothrombin time.

Correct answer: B

Rationale: In clients with cirrhosis, albumin levels are typically decreased due to impaired liver function. Bilirubin levels are often increased in cirrhosis due to the liver's inability to process bilirubin efficiently. Ammonia levels may be elevated in cirrhosis due to impaired ammonia metabolism by the liver. Prothrombin time is usually prolonged in cirrhosis because the liver's ability to synthesize clotting factors is impaired.

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