Nursing Elites

1. A client is admitted to the hospital with a diagnosis of pericarditis. The nurse reviews the client's record for which sign or symptom that differentiates pericarditis from other cardiopulmonary problems?

• A. Anterior chest pain
• B. Pericardial friction rub
• C. Weakness and irritability
• D. Chest pain that worsens with inspiration

Correct answer: B

Rationale: Pericardial friction rub is a distinctive sign of pericarditis, characterized by a scraping or grating sound heard on auscultation, which helps differentiate pericarditis from other cardiopulmonary conditions. While anterior chest pain may be present in various cardiopulmonary issues, it is not specific to pericarditis. Weakness and irritability are nonspecific symptoms that can be seen in many conditions. Chest pain worsening with inspiration is more indicative of pleuritic conditions such as pleurisy or pneumonia, rather than pericarditis.

2. The nurse is reinforcing instructions to a client with coronary artery disease who is prescribed a low-cholesterol diet. The nurse should advise the client to choose which food item?

• A. Eggs and bacon
• B. Oatmeal with fresh fruit
• C. Cream of chicken soup
• D. Grilled cheese sandwich

Correct answer: B

Rationale: Oatmeal with fresh fruit is a suitable choice for a client with coronary artery disease on a low-cholesterol diet as it is low in cholesterol and provides heart-healthy benefits. Eggs and bacon, cream of chicken soup, and grilled cheese sandwich are higher in cholesterol and may not be as heart-healthy for this client. Eggs and bacon are high in cholesterol, cream of chicken soup may contain saturated fats, and a grilled cheese sandwich typically contains high amounts of fat and cholesterol, making them less suitable choices for a client with coronary artery disease on a low-cholesterol diet.

3. Prior to a dipyridamole thallium scan, what substance should the LPN/LVN ensure the client has not consumed?

• A. Caffeine
• B. Fatty meal
• C. Excess sugar
• D. Milk products

Correct answer: A

Rationale: Caffeine should be avoided before a dipyridamole thallium scan as it can interfere with the test results. Caffeine is a stimulant that can affect the heart rate and may lead to inaccurate findings during the scan. Fatty meals, excess sugar, and milk products do not specifically interfere with the dipyridamole thallium scan procedure. Therefore, it is essential for the LPN/LVN to check and ensure that the client has not consumed caffeine prior to the procedure to obtain accurate diagnostic results.

4. 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.

5. The nurse is assisting in the care of a client experiencing an acute myocardial infarction (MI). Which medication would the nurse expect to be administered to help reduce myocardial oxygen demand?

• A. Aspirin
• B. Morphine
• C. Atropine
• D. Lidocaine

Correct answer: B

Rationale: In the context of an acute myocardial infarction (MI), morphine is administered to relieve pain and reduce myocardial oxygen demand. By alleviating pain and anxiety, morphine helps reduce oxygen demand on the heart, which is beneficial in the setting of an MI. Aspirin, commonly used for its antiplatelet effects, helps inhibit platelet aggregation and is crucial in the management of MI to prevent further clot formation. Atropine is a medication used to treat symptomatic bradycardia by increasing heart rate, not commonly indicated in the management of acute MI. Lidocaine is used for ventricular dysrhythmias and is not typically given to reduce myocardial oxygen demand in an acute MI scenario.

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