Nursing Elites

1. A client with a history of hypertension is prescribed lisinopril (Prinivil). Which side effect should the nurse monitor for?

• A. Dry cough.
• B. Weight gain.
• C. Tachycardia.
• D. Hyperglycemia.

Correct answer: A

Rationale: The correct answer is A: Dry cough. Lisinopril is an ACE inhibitor, and a common side effect of ACE inhibitors is a dry cough. This occurs due to the accumulation of bradykinin in the lungs, leading to irritation and subsequent cough. It is important for the nurse to monitor the client for this side effect as it can affect adherence to the medication regimen. Weight gain, tachycardia, and hyperglycemia are not typically associated with lisinopril. Therefore, choices B, C, and D are incorrect.

2. A young adult female client is seen in the emergency department for a minor injury following a motor vehicle collision. She states she is very angry at the person who hit her car. What is the best nursing response?

• A. You are lucky to be alive. Be grateful no one was killed.'
• B. I understand your car was not seriously damaged.'
• C. You are upset that this incident has brought you here.'
• D. Have you ever been in the emergency department before?'

Correct answer: C

Rationale: Validating the client's feelings can help her express and manage her emotions effectively.

3. A patient with depression is prescribed fluoxetine. What is an important side effect for the nurse to monitor?

• A. Weight gain
• B. Bradycardia
• C. Dry mouth
• D. Suicidal thoughts

Correct answer: D

Rationale: When a patient with depression is prescribed fluoxetine, the nurse should be vigilant for the potential side effect of increased risk of suicidal thoughts. Fluoxetine, like other antidepressants, may elevate the risk of suicidal thoughts, particularly during the initial phases of treatment. Monitoring the patient for any indications of heightened depression or suicidal ideation is crucial to ensure appropriate interventions are implemented promptly.

4. A client is admitted with suspected meningitis. Which assessment finding requires immediate intervention?

• A. Headache.
• B. Fever.
• C. Nuchal rigidity.
• D. Seizures.

Correct answer: D

Rationale: Seizures in a client with suspected meningitis indicate increased intracranial pressure or other complications requiring immediate intervention. Seizures can lead to further neurological damage and need prompt management to prevent adverse outcomes. Therefore, addressing seizures promptly is crucial in the care of a client with suspected meningitis.

5. A 34-year-old woman presents with intermittent abdominal pain, bloating, and diarrhea. She notes that her symptoms improve with fasting. She has a history of iron deficiency anemia. What is the most likely diagnosis?

• A. Irritable bowel syndrome
• B. Celiac disease
• C. Lactose intolerance
• D. Crohn's disease

Correct answer: B

Rationale: The patient's symptoms of intermittent abdominal pain, bloating, and diarrhea that improve with fasting, along with a history of iron deficiency anemia, are highly suggestive of celiac disease. In celiac disease, gluten ingestion leads to mucosal damage in the small intestine, causing malabsorption of nutrients like iron, leading to anemia. The improvement of symptoms with fasting can be explained by the temporary avoidance of gluten-containing foods. Irritable bowel syndrome typically does not improve with fasting. Lactose intolerance usually presents with symptoms after dairy consumption, not with fasting. Crohn's disease typically presents with more chronic symptoms and is not commonly associated with improvement on fasting.

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