Nursing Elites

1. A client asks the nurse to explain the difference between stable and unstable angina. What is the best response by the nurse?

• A. "Stable angina is predictable in its frequency, intensity, and duration. Unstable angina is when angina episodes become more frequent or severe, and occur during periods of rest."?
• B. "Unstable angina is caused by spasms of the coronary arteries. Stable angina is when angina episodes become more frequent or severe, and occur during periods of rest."?
• C. "Unstable angina is predictable in its frequency, intensity, and duration. Stable angina is when angina episodes become more frequent or severe, and occur during periods of rest."?
• D. "Stable angina is caused by spasms of the coronary arteries. Unstable angina is when angina episodes become more frequent or severe, and occur during periods of rest."?

Correct answer: A

Rationale: Stable angina is typically triggered by physical exertion or emotional stress and is predictable in its frequency, intensity, and duration. In contrast, unstable angina is characterized by angina episodes that are unexpected, more severe, prolonged, and can occur at rest. Understanding these differences can help healthcare providers assess and manage angina episodes effectively, ensuring appropriate interventions are implemented promptly based on the type of angina present.

2. A client has a new prescription for Alendronate to treat osteoporosis. Which of the following instructions should the nurse include?

• A. Take the medication with a full glass of water after rising in the morning.
• B. Lie down for at least 30 minutes after taking the medication.
• C. Take the medication before bedtime to reduce the risk of esophageal irritation.
• D. Crush the tablet and mix it with applesauce if having difficulty swallowing.

Correct answer: A

Rationale: The correct instruction is to take Alendronate with a full glass of water after rising in the morning. This helps reduce the risk of esophageal irritation, as the medication can cause irritation if not taken correctly. Taking it before bedtime (choice C) can increase the risk of irritation as the individual lies down. Lying down after taking the medication (choice B) can also lead to esophageal irritation. Crushing the tablet (choice D) is not recommended as Alendronate should be taken whole with a full glass of water.

3. A client has a new prescription for Folic Acid. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Expect a metallic taste in your mouth.
• C. Increase your intake of green, leafy vegetables.
• D. Avoid citrus fruits.

Correct answer: C

Rationale: The correct answer is C: 'Increase your intake of green, leafy vegetables.' Folic acid is naturally found in green, leafy vegetables. By increasing the intake of these vegetables, the client can supplement their folic acid levels. This dietary adjustment supports the client in meeting the prescription requirements and enhances the overall health benefits of folic acid. Choices A, B, and D are incorrect because they do not directly relate to increasing folic acid intake as required by the prescription.

4. A client has a new prescription for colchicine to treat gout. Which of the following instructions should be included?

• A. Take this medication with food if nausea develops.
• B. Monitor for muscle pain.
• C. Expect to have increased bruising.
• D. Increase your intake of grapefruit juice.

Correct answer: B

Rationale: Monitoring for muscle pain is crucial when taking colchicine because it can lead to rhabdomyolysis, a serious condition characterized by muscle breakdown. This adverse effect needs prompt identification to prevent complications. Choices A, C, and D are incorrect because taking colchicine with food, experiencing increased bruising, or increasing grapefruit juice intake are not relevant instructions for a client prescribed colchicine for gout.

5. A client prescribed Isosorbide Mononitrate for chronic stable Angina develops reflex tachycardia. Which of the following medications should the nurse expect to administer?

• A. Furosemide
• B. Captopril
• C. Ranolazine
• D. Metoprolol

Correct answer: D

Rationale: Metoprolol, a beta-adrenergic blocker, is commonly used to treat hypertension and stable angina pectoris. It is often prescribed to decrease heart rate in clients who develop tachycardia, such as in the case of reflex tachycardia induced by Isosorbide Mononitrate, making it the appropriate choice in this scenario. Furosemide (Choice A) is a loop diuretic used for conditions like heart failure and edema, not for reflex tachycardia. Captopril (Choice B) is an ACE inhibitor primarily used for hypertension and heart failure, not for reflex tachycardia. Ranolazine (Choice C) is used for chronic angina but does not specifically address reflex tachycardia.

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