Nursing Elites

1. A client with a diagnosis of myocardial infarction has a new activity prescription allowing the client to have bathroom privileges. As the client stands and begins to walk, the client begins to complain of chest pain. The nurse should take which action?

• A. Assist the client to get back into bed.
• B. Report the chest pain episode to the healthcare provider.
• C. Tell the client to stand still and take the client's blood pressure.
• D. Give a nitroglycerin (Nitrostat) tablet and assist the client to the bathroom.

Correct answer: A

Rationale: In a client with myocardial infarction experiencing chest pain during activity, the priority action is to stop the activity immediately to reduce the heart's workload and oxygen demand. Assisting the client back to bed helps in reducing stress on the heart and can prevent worsening of the condition. Reporting the chest pain episode to the healthcare provider is important but should not delay taking immediate action to alleviate symptoms. Taking the client's blood pressure and administering nitroglycerin are secondary actions after ensuring the client's safety and comfort. Therefore, the correct action is to assist the client back into bed.

2. While assessing a client taking propranolol, which finding should the nurse report to the provider?

• A. Bradycardia
• B. Dry mouth
• C. Constipation
• D. Increased appetite

Correct answer: A

Rationale: Bradycardia is a significant side effect of propranolol, a beta-blocker that slows the heart rate. It indicates potential cardiovascular complications and should be reported promptly to the healthcare provider for further evaluation and management. Dry mouth, constipation, and increased appetite are common side effects of various medications but are not directly associated with propranolol's mechanism of action.

3. A client with a history of heart failure is prescribed metoprolol (Lopressor). The nurse should monitor the client for which common side effect of this medication?

• A. Tachycardia
• B. Hypotension
• C. Hypertension
• D. Hyperglycemia

Correct answer: B

Rationale: Metoprolol is a beta-blocker commonly used in heart failure to reduce blood pressure. One of the common side effects of metoprolol is hypotension, which can lead to dizziness, lightheadedness, and even fainting. Therefore, monitoring for hypotension is essential to prevent adverse effects and ensure patient safety. Choices A, C, and D are incorrect. Tachycardia is not a common side effect of metoprolol, as it actually reduces heart rate. Hypertension is also not a common side effect of this medication, as it is intended to lower blood pressure. Hyperglycemia is not a typical side effect of metoprolol.

4. A client with a diagnosis of angina pectoris is prescribed nitroglycerin. The nurse should teach the client to take the medication in which way?

• A. Take one tablet daily with breakfast
• B. Take one tablet every 5 minutes as needed, up to three times
• C. Take one tablet every hour until pain subsides
• D. Take one tablet only if pain does not subside after 30 minutes

Correct answer: B

Rationale: Nitroglycerin is a rapid-acting medication used to relieve angina pain by dilating blood vessels. The correct administration is to take one tablet every 5 minutes as needed, up to three doses. This dosing regimen helps in managing acute angina episodes effectively. Choice A is incorrect because nitroglycerin is not taken once daily. Choice C is incorrect because waiting for an hour between doses may not provide timely relief during angina attacks. Choice D is incorrect as it suggests waiting for 30 minutes before taking another dose, which could delay symptom relief in acute situations.

5. A healthcare professional is assessing a client who has a new prescription for furosemide. Which of the following findings should the healthcare professional report to the provider?

• A. Weight gain
• B. Dry cough
• C. Hypokalemia
• D. Increased appetite

Correct answer: C

Rationale: The correct answer is C: Hypokalemia. Hypokalemia is a common electrolyte imbalance associated with furosemide use due to its diuretic effect, which can lead to potassium loss. It is crucial to report hypokalemia promptly to the provider as it can result in serious complications such as cardiac arrhythmias. Monitoring and managing potassium levels are essential in patients taking furosemide to prevent adverse effects related to electrolyte imbalances. Choices A, B, and D are incorrect findings to report in a client prescribed furosemide. Weight gain is not typically associated with furosemide use, a dry cough is more commonly linked to ACE inhibitors, and increased appetite is not a common adverse effect of furosemide.

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