Nursing Elites

1. A client is admitted to the emergency department with a suspected myocardial infarction (MI). The nurse should prepare the client for which immediate diagnostic test?

• A. Chest x-ray
• B. Electrocardiogram (ECG)
• C. Echocardiogram
• D. Coronary angiography

Correct answer: B

Rationale: An Electrocardiogram (ECG) is the most immediate and essential test to diagnose a myocardial infarction (MI) and assess the extent of heart damage. An ECG can quickly identify changes in the heart's electrical activity, allowing prompt initiation of appropriate interventions. A chest x-ray (Choice A) may show other conditions affecting the heart, but it is not the immediate test of choice for diagnosing an MI. An echocardiogram (Choice C) and coronary angiography (Choice D) are valuable in further assessing cardiac function and anatomy post-MI but are not the first-line diagnostic tests due to their time-consuming nature compared to an ECG.

2. A healthcare professional is assessing a client who has been taking isoniazid to treat tuberculosis. The healthcare professional should monitor the client for which of the following findings as an adverse effect of the medication?

• A. Diarrhea
• B. Blurred vision
• C. Hearing loss
• D. Jaundice

Correct answer: D

Rationale: Correct. Jaundice is a serious adverse effect of isoniazid due to liver damage. It is essential to monitor for signs of liver toxicity, such as jaundice, while the client is on this medication. Diarrhea is a common side effect of isoniazid, but it is not as serious as liver damage. Blurred vision and hearing loss are not typically associated with isoniazid use.

3. The nurse is assisting in the care of a client with a history of chronic obstructive pulmonary disease (COPD) who is on oxygen therapy. Which action should the nurse take to ensure the client's safety?

• A. Set the oxygen flow rate to 4 liters per minute.
• B. Remove oxygen while the client is eating.
• C. Ensure the client wears a nasal cannula instead of a face mask.
• D. Maintain the oxygen flow rate at the lowest level that relieves hypoxia.

Correct answer: D

Rationale: For clients with COPD, too much oxygen can suppress their drive to breathe, leading to hypoventilation. Therefore, the nurse should maintain the oxygen flow rate at the lowest level that relieves hypoxia to prevent complications while ensuring adequate oxygenation. Setting the oxygen flow rate too high (Choice A) can be detrimental for the client with COPD. Removing oxygen while the client is eating (Choice B) can compromise oxygenation, which is essential even during meals. While nasal cannulas are commonly used, the choice of oxygen delivery device depends on the client's needs; there may be situations where a face mask (Choice C) is more appropriate.

4. An ambulatory clinic nurse is interviewing a client who is complaining of flu-like symptoms. The client suddenly develops chest pain. Which question best assists the nurse in discriminating pain caused by a non-cardiac problem?

• A. Can you describe the pain to me?
• B. Have you ever experienced this pain before?
• C. Does the pain get worse when you breathe in?
• D. Can you rate the pain on a scale of 1 to 10, with 10 being the worst?

Correct answer: C

Rationale: The correct answer is C. Pain that worsens with breathing in can indicate pleuritic chest pain, which is non-cardiac in nature. This specific question helps in differentiating non-cardiac causes from cardiac causes of chest pain, as cardiac pain typically does not worsen with breathing. Choices A, B, and D are less specific in discriminating between cardiac and non-cardiac chest pain.

5. The nurse is teaching a client with coronary artery disease (CAD) about the risk factors for the disease. Which modifiable risk factor should the nurse emphasize?

• A. Family history
• B. Age
• C. Cigarette smoking
• D. Gender

Correct answer: C

Rationale: Cigarette smoking is a modifiable risk factor for coronary artery disease (CAD) as it can be changed or controlled to reduce the risk of developing CAD. Family history, age, and gender are non-modifiable risk factors that cannot be changed. Emphasizing the importance of quitting smoking can help the client reduce their risk of CAD and improve their overall cardiovascular health. Therefore, the correct answer is C. Choice A (Family history), B (Age), and D (Gender) are non-modifiable risk factors and not the focus of modifiable risk reduction strategies in CAD prevention.

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