Nokea
What is the most concerning electrolyte imbalance for a patient receiving digoxin?
- A. Hyperkalemia
- B. Hypokalemia
- C. Hyponatremia
- D. Hypercalcemia
Correct Answer: B
Rationale: The correct answer is Hypokalemia. Hypokalemia is the most concerning electrolyte imbalance for a patient receiving digoxin because it can increase the risk of digoxin toxicity. Low potassium levels can potentiate the effects of digoxin on the heart, leading to serious cardiac arrhythmias. Hyperkalemia (Choice A) is not typically associated with digoxin use. Hyponatremia (Choice C) and Hypercalcemia (Choice D) are not directly related to digoxin therapy and do not pose the same risk of toxicity.
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What is the most important nursing intervention for a patient experiencing an acute asthma attack?
- A. Administer bronchodilators
- B. Provide supplemental oxygen
- C. Start IV fluids
- D. Monitor oxygen saturation
Correct Answer: A
Rationale: The correct answer is to administer bronchodilators. During an acute asthma attack, bronchodilators like albuterol are crucial to help dilate the airways and improve breathing. Providing supplemental oxygen (Choice B) may be necessary but is not the priority intervention. Starting IV fluids (Choice C) and monitoring oxygen saturation (Choice D) are important aspects of care but are not the most critical interventions during an acute asthma attack.
Which laboratory test is essential for monitoring renal function in a patient with chronic kidney disease?
- A. Monitor BUN and creatinine levels
- B. Check blood glucose levels
- C. Monitor hemoglobin and hematocrit levels
- D. Monitor liver enzymes
Correct Answer: A
Rationale: The correct answer is to monitor BUN (Blood Urea Nitrogen) and creatinine levels in a patient with chronic kidney disease. These tests provide crucial information about renal function. Checking blood glucose levels (Choice B) is important for monitoring diabetes, not renal function. Monitoring hemoglobin and hematocrit levels (Choice C) helps assess anemia, not specifically renal function. Monitoring liver enzymes (Choice D) is relevant for assessing liver function, not renal function.
Four clients present to the emergency department. The nurse should plan to see which of the following clients first?
- A. A 6-year-old client with a dislocated left shoulder
- B. A 26-year-old client with sickle cell disease and severe joint pain
- C. A 76-year-old client who is confused, febrile, and has foul-smelling urine
- D. A 50-year-old client with slurred speech, disorientation, and headache
Correct Answer: D
Rationale: The correct answer is D. A client presenting with symptoms of a stroke, such as slurred speech, disorientation, and headache, requires immediate attention due to the possibility of a neurological emergency. Choices A, B, and C, although concerning, do not present with symptoms as urgent as those of a potential stroke. Dislocated shoulder, sickle cell disease with joint pain, and confusion with febrile illness can be addressed after ensuring the client with stroke-like symptoms receives prompt evaluation and intervention.
A patient is diagnosed with deep vein thrombosis (DVT). Which of the following actions should the nurse take?
- A. Massage the affected extremity every 2 hours.
- B. Encourage the patient to ambulate as soon as possible.
- C. Apply warm compresses to the affected extremity.
- D. Elevate the affected extremity.
Correct Answer: D
Rationale: Elevating the affected extremity is crucial in managing deep vein thrombosis (DVT) as it helps reduce swelling and promotes venous return, thereby preventing further complications such as pulmonary embolism. Massaging the affected extremity can dislodge a clot and lead to serious consequences. While ambulation is important, in DVT, early ambulation without elevation can potentially dislodge the clot. Warm compresses can increase blood flow to the area and worsen the condition by promoting clot dislodgement.
A client is receiving a new prescription for enoxaparin. Which of the following instructions should the nurse include?
- A. Rub the injection site after administration.
- B. Pinch the skin while administering the injection.
- C. Aspirate before administering the medication.
- D. Avoid taking aspirin while using this medication.
Correct Answer: D
Rationale: The correct answer is D: 'Avoid taking aspirin while using this medication.' Enoxaparin is an anticoagulant medication, and taking aspirin concurrently can increase the risk of bleeding. Choices A, B, and C are incorrect. A nurse should not instruct the client to rub the injection site after administration as it may cause irritation. Pinching the skin while administering the injection is not recommended for enoxaparin injections. Aspirating before administering the medication is also unnecessary as enoxaparin is administered subcutaneously, not intramuscularly.