Nursing Elites

1. A client with a history of myocardial infarction (MI) is prescribed atorvastatin (Lipitor). Which outcome indicates that the medication is effective?

• A. Increased blood pressure.
• B. Lowered cholesterol levels.
• C. Decreased heart rate.
• D. Improved liver function.

Correct answer: B

Rationale: The correct answer is B: Lowered cholesterol levels. Atorvastatin is a medication commonly prescribed to lower cholesterol levels, which is crucial in reducing the risk of further cardiovascular events, including myocardial infarction (MI). Monitoring cholesterol levels is essential to assess the effectiveness of atorvastatin therapy and its role in preventing future cardiac complications. Choices A, C, and D are incorrect because increased blood pressure, decreased heart rate, and improved liver function are not direct indicators of atorvastatin's effectiveness in a client with a history of MI.

2. The mental health nurse observes that a female client with delusional disorder carries some of her belongings with her because she believes that others are trying to steal them. Which nursing action will promote trust?

• A. Explain that distrust is related to feeling anxious.
• B. Initiate short, frequent contacts with the client.
• C. Explain that these beliefs are related to her illness.
• D. Offer to keep the belongings at the nurse's desk.

Correct answer: B

Rationale: Initiating short, frequent contacts with the client is the most appropriate action to promote trust. This approach helps build trust and rapport, addressing the client's need for security. By maintaining regular contact, the nurse can provide reassurance and support, which can help alleviate the client's anxiety related to her delusional beliefs. Choice A does not directly address the client's need for trust and security. Choice C focuses on the client's illness but does not actively address building trust. Choice D, offering to keep the belongings at the nurse's desk, may not be well-received by the client and could potentially worsen her anxiety and distrust.

3. A client with peptic ulcer disease is prescribed omeprazole (Prilosec). Which instruction should the nurse include in the client's teaching plan?

• A. Take the medication with food.
• B. Take the medication at bedtime.
• C. Take the medication on an empty stomach.
• D. Take the medication as needed for pain relief.

Correct answer: C

Rationale: The correct instruction for a client prescribed omeprazole (Prilosec) is to take the medication on an empty stomach. This is important for optimal absorption and effectiveness of the medication in treating peptic ulcer disease. Choice A ('Take the medication with food') is incorrect because omeprazole should be taken on an empty stomach. Choice B ('Take the medication at bedtime') is incorrect as it does not align with the optimal timing for omeprazole administration. Choice D ('Take the medication as needed for pain relief') is incorrect because omeprazole is not typically used for immediate pain relief but rather for long-term management of peptic ulcer disease.

4. A client receiving total parenteral nutrition (TPN) through a central line suddenly develops dyspnea, chest pain, and a drop in blood pressure. What should the nurse do first?

• A. Stop the TPN infusion.
• B. Notify the healthcare provider.
• C. Place the client in Trendelenburg position.
• D. Administer oxygen at 2 liters/minute.

Correct answer: C

Rationale: Placing the client in Trendelenburg position should be the initial action as it can help manage a suspected air embolism, a potential complication of TPN administration. This position helps trap air in the apex of the atrium, reducing the risk of air reaching the pulmonary circulation and causing further harm. Once the client is in a safe position, further actions such as stopping the TPN infusion, notifying the healthcare provider, and administering oxygen can be taken as appropriate.

5. The client was recently diagnosed with chronic gastritis. What health practice should the nurse address when teaching the client to limit exacerbations of the disease?

• A. Perform 15 minutes of physical activity at least three times per week.
• B. Avoid taking aspirin to treat pain or fever.
• C. Take multivitamins as prescribed and eat organic foods whenever possible.
• D. Maintain a healthy body weight.

Correct answer: B

Rationale: The correct answer is B. Avoiding aspirin is crucial in managing chronic gastritis as it can further irritate the stomach lining, leading to exacerbations of the condition. Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that can increase stomach acid production, potentially worsening gastritis symptoms. Therefore, the nurse should educate the client on using alternative pain or fever relief methods that are less likely to aggravate gastritis, such as acetaminophen.

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