Nursing Elites

1. A client with chronic obstructive pulmonary disease (COPD) is prescribed theophylline. The nurse should monitor the client for which sign of theophylline toxicity?

• A. Drowsiness
• B. Bradycardia
• C. Nausea
• D. Constipation

Correct answer: C

Rationale: Nausea is an early sign of theophylline toxicity. The nurse should closely monitor the client for this symptom as it can progress to more severe toxicity. Nausea can be a warning sign to prevent further complications and adjust the dosage as necessary. Drowsiness (choice A) is a common side effect of theophylline but not a specific sign of toxicity. Bradycardia (choice B) and constipation (choice D) are not typically associated with theophylline toxicity. Therefore, the correct answer is C.

2. What should be the nurse's priority action when a client diagnosed with angina pectoris complains of chest pain while taking a brisk walk?

• A. Administer nitroglycerin
• B. Have the client sit down
• C. Obtain an electrocardiogram
• D. Apply oxygen

Correct answer: B

Rationale: The nurse's priority action when a client diagnosed with angina pectoris complains of chest pain while taking a brisk walk is to have the client sit down. Sitting down reduces the workload on the heart and may alleviate pain by improving oxygen supply. This action aims to reduce the strain on the heart and improve oxygen delivery to the myocardium, which can help relieve the symptoms of angina pectoris. Administering nitroglycerin could be the next step after having the client sit down if the pain persists. Obtaining an electrocardiogram and applying oxygen are not the immediate priority actions when dealing with angina pectoris symptoms.

3. After a client with a history of myocardial infarction (MI) is prescribed aspirin, which instruction should the nurse include in the discharge teaching?

• A. Take the aspirin with food to prevent gastrointestinal upset
• B. Discontinue the aspirin if you experience ringing in your ears
• C. Take the aspirin at bedtime to minimize side effects
• D. Avoid taking aspirin if you are also taking other NSAIDs

Correct answer: A

Rationale: The correct instruction is to take aspirin with food to prevent gastrointestinal upset. Aspirin can irritate the stomach lining, leading to potential gastrointestinal issues. Taking it with food helps reduce this risk by providing a protective layer in the stomach. This is a common recommendation to minimize the risk of gastrointestinal side effects when taking aspirin. Choices B, C, and D are incorrect. Choice B is not a typical reason to discontinue aspirin, as ringing in the ears is not a common side effect of aspirin. Choice C does not have a direct correlation to minimizing side effects of aspirin. Choice D is inaccurate because while caution should be exercised when taking aspirin with other NSAIDs due to the increased risk of bleeding, it does not mean aspirin should be entirely avoided if other NSAIDs are being taken.

4. A client has a new prescription for verapamil. Which of the following instructions should the nurse include?

• A. Monitor your heart rate daily.
• B. Take the medication at bedtime.
• C. Avoid consuming grapefruit juice.
• D. Take the medication with food.

Correct answer: A

Rationale: The correct answer is to instruct the client to monitor their heart rate daily when taking verapamil. Verapamil is a calcium channel blocker that can cause bradycardia, making it crucial to monitor the heart rate regularly to detect any changes promptly. Choice B, taking the medication at bedtime, is not specifically related to verapamil administration. Choice C, avoiding grapefruit juice, is more relevant to medications metabolized by CYP3A4 enzymes, not verapamil. Choice D, taking the medication with food, is not a specific instruction for verapamil, as it can be taken with or without food.

5. The healthcare professional is caring for a client who has just returned from a cardiac catheterization. The healthcare professional should prioritize which assessment?

• A. Monitoring the client's vital signs every 4 hours
• B. Assessing the puncture site for bleeding
• C. Encouraging the client to ambulate early to prevent complications
• D. Providing the client with fluids to flush out the contrast dye

Correct answer: B

Rationale: Assessing the puncture site for bleeding is a critical assessment after a cardiac catheterization procedure. This is essential to detect and address any potential complications promptly, such as hemorrhage or hematoma formation. Monitoring vital signs, encouraging early ambulation, and providing fluids to flush out contrast dye are important aspects of post-cardiac catheterization care, but assessing the puncture site for bleeding takes precedence due to the immediate risk of complications such as severe bleeding that require immediate intervention.

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