Nursing Elites

1. A client admitted with coronary artery disease (CAD) reports dyspnea at rest. What intervention should the nurse prioritize?

• A. Providing a walker to aid in ambulation
• B. Elevating the head of the bed to at least 45 degrees
• C. Performing continuous monitoring of oxygen saturation
• D. Placing an oxygen cannula at the bedside for use if needed

Correct answer: B

Rationale: In a client with coronary artery disease (CAD) experiencing dyspnea at rest, the priority intervention should be to elevate the head of the bed to at least 45 degrees. This position helps reduce the work of breathing, optimizes lung expansion, and can alleviate symptoms of dyspnea by improving oxygenation and ventilation. Providing a walker for ambulation, monitoring oxygen saturation, and having an oxygen cannula at the bedside are important interventions but not the priority when the client is experiencing dyspnea at rest. Elevating the head of the bed is crucial to improve respiratory function and should be prioritized in this situation.

2. A client has a new prescription for atenolol. Which of the following instructions should be included in the discharge teaching?

• A. Take the medication at bedtime.
• B. Monitor your heart rate daily.
• C. Increase your intake of potassium-rich foods.
• D. Avoid consuming dairy products.

Correct answer: B

Rationale: The correct answer is to instruct the client to monitor their heart rate daily when taking atenolol. Atenolol can lead to bradycardia, a slow heart rate. By monitoring heart rate daily, the client can promptly identify any significant changes and seek medical attention if necessary. This proactive approach enables early detection of potential adverse effects of atenolol, contributing to the client's safety and well-being. Choices A, C, and D are incorrect because taking atenolol at bedtime, increasing potassium-rich foods intake, or avoiding dairy products are not specific instructions related to the potential side effects of atenolol.

3. A 24-year-old man seeks medical attention for complaints of claudication in the arch of the foot. The nurse also notes superficial thrombophlebitis of the lower leg. What should the nurse check the client for next?

• A. Smoking history
• B. Recent exposure to allergens
• C. History of recent insect bites
• D. Familial tendency toward peripheral vascular disease

Correct answer: A

Rationale: In this case, the nurse should check the client's smoking history next. Smoking is a significant risk factor for peripheral vascular disease, leading to the development of thrombophlebitis and claudication. It is important to assess this risk factor as it can significantly impact the client's vascular health and the progression of their current symptoms. Choices B, C, and D are incorrect because they are not directly related to the symptoms described by the client. Recent exposure to allergens or insect bites would typically present with different symptoms, and familial tendency toward peripheral vascular disease is not the immediate concern in this case.

4. A healthcare professional is assessing a client who is taking levodopa/carbidopa. Which of the following findings should the healthcare professional report to the provider?

• A. Weight gain
• B. Urinary retention
• C. Bradykinesia
• D. Dry mouth

Correct answer: C

Rationale: Corrected Rationale: Bradykinesia is a cardinal symptom of Parkinson's disease characterized by slowness of movement. An increase in bradykinesia may indicate a worsening of the disease and the need for adjustments in medication or other interventions. Therefore, it is crucial for the healthcare professional to report this finding to the provider promptly for further evaluation and management. Weight gain, urinary retention, and dry mouth are not directly associated with levodopa/carbidopa therapy or indicative of a worsening condition in Parkinson's disease, making them less urgent findings to report to the provider.

5. When teaching a client about the adverse effects of simvastatin, which of the following findings should be included as an adverse effect?

• A. Tinnitus
• B. Muscle pain
• C. Diarrhea
• D. Facial flushing

Correct answer: B

Rationale: Muscle pain should be included as an adverse effect when teaching a client about simvastatin. It can be a sign of rhabdomyolysis, a severe side effect associated with statins like simvastatin that involves muscle breakdown. Monitoring for muscle pain is crucial to prevent serious complications and ensure timely intervention. Tinnitus, diarrhea, and facial flushing are not typically associated with simvastatin use and are less common adverse effects compared to muscle pain.

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