Nursing Elites

1. A client with a diagnosis of hypertension is prescribed atenolol (Tenormin). The nurse should monitor the client for which common side effect of this medication?

• A. Tachycardia
• B. Dry mouth
• C. Hypotension
• D. Increased appetite

Correct answer: C

Rationale: Corrected Rationale: Atenolol is a beta-blocker that commonly causes hypotension by lowering blood pressure. Therefore, monitoring for hypotension is crucial to prevent potential complications in the client receiving this medication. The other options are incorrect: A) Tachycardia is not a common side effect of atenolol as it typically reduces heart rate, B) Dry mouth is not a typical side effect of atenolol, and D) Increased appetite is not commonly associated with atenolol use.

2. A client is scheduled for a coronary artery bypass graft (CABG) surgery. The nurse should prepare the client by reinforcing information about which post-operative care measure?

• A. You will be on bed rest for the first 48 hours after surgery.
• B. You will be encouraged to cough and deep breathe frequently.
• C. You will be discharged within 24 hours if no complications arise.
• D. You will not be able to eat or drink for 24 hours after surgery.

Correct answer: B

Rationale: Encouraging the client to cough and deep breathe frequently is essential post-operative care to prevent respiratory complications such as atelectasis and pneumonia after CABG surgery. Choices A, C, and D are incorrect because post-CABG surgery, early mobilization is encouraged to prevent complications such as deep vein thrombosis (DVT) and pneumonia. Discharge within 24 hours is unlikely after CABG surgery, and early oral intake is encouraged to promote recovery and prevent complications.

3. When educating a client about the use of risedronate to treat osteoporosis, which instruction should be included?

• A. Drink a full glass of water with each dose.
• B. Take the medication on an empty stomach.
• C. Remain upright for 30 minutes after taking the medication.
• D. Avoid lying down for at least 1 hour after taking the medication.

Correct answer: C

Rationale: The correct instruction for a client taking risedronate to treat osteoporosis is to remain upright for 30 minutes after taking the medication. This is important to prevent esophageal irritation, as risedronate can cause irritation if it remains in contact with the esophagus. By staying upright, the medication is more likely to reach the stomach quickly and reduce the risk of irritation to the esophagus. Choices A, B, and D are incorrect. Drinking a full glass of water is recommended, not milk, to help with swallowing the medication. Risedronate should be taken on an empty stomach, not with meals, to ensure proper absorption. Additionally, avoiding lying down for at least 1 hour after taking the medication helps prevent esophageal irritation.

4. A client is admitted with coronary artery disease (CAD) and reports dyspnea at rest. What is the nurse's priority intervention?

• A. Elevate the head of the bed.
• B. Administer oxygen.
• C. Perform continuous ECG monitoring.
• D. Apply a nasal cannula.

Correct answer: A

Rationale: The nurse's priority intervention for a client with coronary artery disease (CAD) experiencing dyspnea at rest is to elevate the head of the bed. Elevating the head of the bed helps improve lung expansion and reduces the workload on the heart, aiding in respiratory effort and cardiac function. This intervention is crucial in enhancing oxygenation and optimizing cardiac output in individuals with CAD presenting with dyspnea. Administering oxygen (Choice B) is important but elevating the head of the bed takes precedence as it directly addresses the client's respiratory distress. Continuous ECG monitoring (Choice C) and applying a nasal cannula (Choice D) are relevant interventions but not the priority when a client with CAD reports dyspnea at rest.

5. A client is receiving intravenous heparin therapy for the treatment of deep vein thrombosis (DVT). Which laboratory test result should the LPN/LVN monitor to ensure the client is receiving a therapeutic dose?

• A. Prothrombin time (PT)
• B. Activated partial thromboplastin time (aPTT)
• C. International normalized ratio (INR)
• D. Platelet count

Correct answer: B

Rationale: The correct laboratory test result that the LPN/LVN should monitor to ensure the client is receiving a therapeutic dose of heparin therapy is the activated partial thromboplastin time (aPTT). The aPTT test is specifically used to monitor heparin therapy, ensuring that the dose administered is within the therapeutic range. Monitoring aPTT helps to prevent complications such as bleeding or clot formation by maintaining the appropriate anticoagulant effect of heparin. Prothrombin time (PT) and International normalized ratio (INR) are more commonly used to monitor warfarin therapy, not heparin. Platelet count is not a direct indicator of heparin's therapeutic effect and is not used to monitor heparin therapy.

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