Nursing Elites

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

• A. Hypokalemia
• B. Hyperglycemia
• C. Persistent cough
• D. Tachycardia

Correct answer: C

Rationale: The correct answer is C: Persistent cough. Lisinopril is an ACE inhibitor commonly associated with a persistent dry cough as a side effect. This cough is thought to result from increased bradykinin levels. Choices A, B, and D are incorrect. Hypokalemia is not a common side effect of lisinopril; in fact, it may lead to hyperkalemia. Hyperglycemia is not a typical side effect of lisinopril use. Tachycardia is also not a common side effect associated with ACE inhibitors like lisinopril.

2. A client with a diagnosis of chronic heart failure is receiving digoxin. What is the most important assessment before administering this medication?

• A. Check blood pressure.
• B. Assess heart rate.
• C. Monitor respiratory rate.
• D. Measure oxygen saturation.

Correct answer: B

Rationale: The correct answer is to assess the heart rate. Before administering digoxin, it is essential to evaluate the heart rate as digoxin can cause bradycardia. While checking blood pressure, monitoring respiratory rate, and measuring oxygen saturation are important assessments in the care of a client with chronic heart failure, assessing the heart rate is particularly critical due to the medication's potential impact on heart rhythm.

3. After a 26-year-old gravida 4, para 0 experienced a spontaneous abortion at 9 weeks gestation, how should the nurse intervene after observing the client crying softly one hour post dilation and curettage (D&C)?

• A. Offer to call the social worker to discuss the possibility of adoption
• B. Reassure the client that the infertility specialist can help
• C. Express sorrow for the client's grief and offer to sit with her
• D. Chart the vital signs and amount of vaginal bleeding

Correct answer: C

Rationale: After a traumatic experience like a spontaneous abortion, it is crucial for the nurse to provide emotional support. Expressing sorrow for the client's grief and offering to sit with her demonstrates empathy and allows the client to process her emotions. Options A and B focus on future possibilities and medical interventions, which may not be immediately appropriate. Option D, while important for monitoring the client's physical status, does not address the client's emotional needs at that moment.

4. A client has a prescription for enteric-coated (EC) aspirin 325mg PO daily. The medication drawer contains one 325mg aspirin. What action should the nurse take?

• A. Contact the pharmacy and request the prescribed form of aspirin
• B. Instruct the client about the effects of the medication
• C. Administer the aspirin with a full glass of water or a small snack
• D. Withhold the aspirin until consulting with the healthcare provider

Correct answer: A

Rationale: The correct action for the nurse to take is to contact the pharmacy and request the prescribed form of aspirin. Enteric-coated medications are designed to dissolve in the intestine, not the stomach, to avoid irritation. Therefore, it is essential to ensure the client receives the correct form of aspirin as prescribed. Instructing the client about the effects of the medication (choice B) is not necessary at this point as the issue is related to the form of the aspirin. Administering the aspirin with a full glass of water or a small snack (choice C) is not appropriate as it does not address the need for the correct form of the medication. Withholding the aspirin (choice D) without consulting the healthcare provider is not advisable as it may lead to a delay in the client receiving the necessary medication.

5. The client with newly diagnosed peptic ulcer disease (PUD) is being taught about lifestyle modifications. Which instruction should be included?

• A. Increase the intake of spicy foods
• B. Avoid the use of nonsteroidal anti-inflammatory drugs (NSAIDs)
• C. Drink coffee in moderation
• D. Eat large meals at bedtime

Correct answer: B

Rationale: The correct instruction to include when teaching a client with newly diagnosed PUD about lifestyle modifications is to avoid the use of nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs can exacerbate peptic ulcer disease by causing further irritation of the gastric mucosa. Increasing the intake of spicy foods (choice A) can aggravate the condition by irritating the stomach lining. Drinking coffee (choice C) can stimulate gastric acid secretion, which may worsen the symptoms of PUD. Eating large meals at bedtime (choice D) can also exacerbate PUD by increasing gastric acid production when the body is at rest, potentially leading to discomfort and symptoms.

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