Nursing Elites

1. A client is diagnosed with Angina Pectoris. Which factor in the client's history is likely related to the anginal pain?

• A. Smokes one pack of cigarettes daily
• B. Drinks two beers daily
• C. Works in a job that requires exposure to the sun
• D. Eats while lying in bed

Correct answer: A

Rationale: The correct answer is A: 'Smokes one pack of cigarettes daily.' Smoking is a major risk factor for angina and other cardiovascular diseases due to its impact on blood vessels. Choice B, 'Drinks two beers daily,' is not directly associated with angina pectoris. While excessive alcohol consumption can contribute to heart problems, it is not a primary risk factor for angina. Choice C, 'Works in a job that requires exposure to the sun,' is not typically related to angina pectoris. Sun exposure is more closely linked to skin-related conditions. Choice D, 'Eats while lying in bed,' is also not a common risk factor for angina. While certain eating habits can impact heart health, this specific behavior is not directly associated with angina pectoris.

2. A client with a history of hypertension is prescribed hydrochlorothiazide (HCTZ). Which adverse effect should the nurse monitor for?

• A. Hyperkalemia
• B. Hyponatremia
• C. Bradycardia
• D. Hyperglycemia

Correct answer: B

Rationale: The correct answer is 'B. Hyponatremia.' Hydrochlorothiazide can lead to electrolyte imbalances, such as hyponatremia, due to its diuretic effect. This potential adverse effect should be closely monitored in patients taking HCTZ. Choice A, hyperkalemia, is less likely to occur with HCTZ as it tends to cause hypokalemia. Choice C, bradycardia, is not a common adverse effect of HCTZ. Choice D, hyperglycemia, is also less commonly associated with HCTZ use compared to hyponatremia.

3. The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who is experiencing shortness of breath. What is the priority nursing intervention?

• A. Administer bronchodilator therapy as prescribed.
• B. Inhale the medication slowly while pressing down on the inhaler.
• C. Position the client in a high-Fowler's position.
• D. Increase the oxygen flow rate.

Correct answer: C

Rationale: The priority nursing intervention for a client with COPD experiencing shortness of breath is to position the client in a high-Fowler's position. This position helps improve lung expansion and ease breathing by maximizing chest expansion and allowing for better airflow. While administering bronchodilator therapy is important, positioning the client for improved breathing takes priority. Inhaling the medication slowly and pressing down on the inhaler is a correct technique for inhaler use but not the priority intervention. Increasing the oxygen flow rate may be needed, but adjusting the client's position to a high-Fowler's position is the priority to address the shortness of breath in COPD.

4. A client who is 24 weeks pregnant presents with a complaint of feeling dizzy when lying on her back. What is the best response by the nurse?

• A. Advise the client to lie on her side
• B. Encourage the client to drink more fluids
• C. Suggest the client elevate her legs when lying down
• D. Recommend the client take short walks throughout the day

Correct answer: A

Rationale: The correct answer is to advise the client to lie on her side. Lying on the side can prevent the compression of the vena cava, which can cause dizziness in pregnant women. Encouraging the client to drink more fluids (Choice B) may be beneficial for other conditions but is not the best response for dizziness when lying on her back. Suggesting the client elevate her legs when lying down (Choice C) is not directly related to the issue described by the client. Recommending the client take short walks throughout the day (Choice D) may be helpful for other pregnancy-related symptoms but is not the most appropriate action for dizziness when lying on her back.

5. The nurse is caring for a client who has just returned from surgery with an indwelling urinary catheter in place. What is the most important assessment for the nurse to make?

• A. Check for catheter patency
• B. Assess the color of the urine
• C. Measure the urine output
• D. Ensure the catheter tubing is secure

Correct answer: C

Rationale: The most important assessment for the nurse to make in this situation is to measure the urine output. This assessment is crucial in monitoring kidney function and fluid balance after surgery. While checking for catheter patency is important, it is not as critical as measuring urine output. Assessing the color of the urine can provide some information about kidney function, but measuring output gives a more accurate assessment. Ensuring the catheter tubing is secure is essential to prevent dislodgement but is not the most critical assessment to make at this time.

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