Nursing Elites

1. Which of the following drugs has a therapeutic effect that increases cardiac output and slows heart rate?

• A. Heparin
• B. Alprazolam
• C. Digoxin
• D. Levothyroxine

Correct answer: C

Rationale: Digoxin is the correct answer. It is a medication known for its positive inotropic effects, which increase cardiac output, and negative chronotropic effects, which slow the heart rate. These effects are achieved by inhibiting the sodium-potassium ATPase pump in myocardial cells. Therefore, Digoxin is commonly prescribed to manage conditions like heart failure and atrial fibrillation, where enhancing cardiac output and reducing heart rate are beneficial. Choices A, B, and D are incorrect because Heparin is an anticoagulant, Alprazolam is a benzodiazepine used for anxiety disorders, and Levothyroxine is a thyroid hormone replacement drug, none of which have the specified therapeutic effects on cardiac function.

2. A client is taking Furosemide for heart failure. Which of the following findings is a priority to report to the provider?

• A. Weight loss of 1 kg in 24 hours
• B. Blood pressure of 104/60 mm Hg
• C. Potassium level of 3.5 mEq/L
• D. Urine output of 200 mL in 8 hours

Correct answer: D

Rationale: A urine output of 200 mL in 8 hours indicates decreased kidney function, potentially due to Furosemide therapy. This finding can suggest inadequate renal perfusion and impaired drug clearance, necessitating immediate reporting to prevent further complications like electrolyte imbalances and worsening heart failure. Choice A: Weight loss may be expected in heart failure patients due to fluid retention, but it is not an immediate concern. Choice B: A blood pressure of 104/60 mm Hg is slightly low but not a priority compared to the indication of kidney dysfunction. Choice C: A potassium level of 3.5 mEq/L is within the normal range, so it does not require immediate reporting.

3. A client has a new prescription for Enalapril. Which of the following adverse effects should the nurse monitor?

• A. Dry cough
• B. Weight gain
• C. Diarrhea
• D. Nausea

Correct answer: A

Rationale: Corrected Rationale: Enalapril, an ACE inhibitor, commonly causes a persistent dry cough as an adverse effect. The nurse should closely monitor the client for this and instruct them to report it to the healthcare provider if it occurs. Choices B, C, and D are incorrect as weight gain, diarrhea, and nausea are not commonly associated adverse effects of Enalapril.

4. A client is starting therapy with Metformin. Which of the following instructions should be included by the healthcare provider?

• A. Take this medication with your first bite of food.
• B. Take this medication on an empty stomach.
• C. Take this medication before bedtime.
• D. Take this medication every other day.

Correct answer: A

Rationale: The correct answer is A: 'Take this medication with your first bite of food.' Metformin should be taken with meals to reduce gastrointestinal side effects and ensure better absorption. By taking the medication with the first bite of food, the client can help minimize potential stomach upset and improve the drug's effectiveness. Choice B is incorrect because taking Metformin on an empty stomach can increase the risk of gastrointestinal side effects. Choice C is incorrect as there is no specific recommendation to take Metformin before bedtime. Choice D is incorrect because Metformin is typically taken daily, not every other day, as prescribed by the healthcare provider.

5. A client has a new prescription for atenolol. Which of the following findings should the nurse instruct the client to monitor for as an adverse effect of this medication?

• A. Tachycardia
• B. Hypoglycemia
• C. Bradycardia
• D. Hypertension

Correct answer: C

Rationale: The correct answer is 'C: Bradycardia.' Atenolol, a beta-blocker, commonly causes bradycardia as an adverse effect. It works by slowing down the heart rate, which can lead to a decreased heart rate known as bradycardia. Monitoring for signs of bradycardia is essential to prevent any potential complications while on atenolol. Choices A, B, and D are incorrect because atenolol is not known to cause tachycardia, hypoglycemia, or hypertension as common adverse effects.

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