Nursing Elites

1. A client with coronary artery disease is prescribed a low-cholesterol diet. The nurse should reinforce which dietary selection made by the client?

• A. Eggs and bacon
• B. Oatmeal with fresh fruit
• C. Cream of chicken soup
• D. Grilled cheese sandwich

Correct answer: B

Rationale: Oatmeal with fresh fruit is a suitable choice for a client with coronary artery disease prescribed a low-cholesterol diet. This option is high in fiber and nutrients, making it a heart-healthy selection. Oatmeal and fresh fruits are low in cholesterol and saturated fats, which helps in managing coronary artery disease. Choices A, C, and D are higher in cholesterol and saturated fats, which can be detrimental for individuals with this condition.

2. A client is prescribed clopidogrel. What laboratory result should be monitored by the nurse?

• A. White blood cell count
• B. Creatinine
• C. Blood glucose
• D. Platelet count

Correct answer: D

Rationale: When a client is prescribed clopidogrel, monitoring the platelet count is essential. Clopidogrel is an antiplatelet medication that works by preventing blood clots. Monitoring the platelet count is crucial in assessing the risk of thrombocytopenia, a potential side effect of clopidogrel. Monitoring white blood cell count, creatinine, or blood glucose is not directly related to the action or side effects of clopidogrel, making choices A, B, and C incorrect.

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

• A. Frequent urination
• B. Dry cough
• C. Tremors
• D. Dizziness

Correct answer: B

Rationale: The correct answer is B: Dry cough. A dry cough is a common side effect of enalapril that can indicate the development of angioedema or potentially life-threatening angioedema. An onset of dry cough should be reported to the provider promptly as it may require discontinuation of the medication to prevent further complications. Frequent urination, tremors, and dizziness are not typically associated with enalapril use and are less likely to be of immediate concern compared to a dry cough in this context.

4. A client is admitted to the emergency department with a suspected myocardial infarction (MI). The nurse should prepare the client for which immediate diagnostic test?

• A. Chest x-ray
• B. Electrocardiogram (ECG)
• C. Echocardiogram
• D. Coronary angiography

Correct answer: B

Rationale: An Electrocardiogram (ECG) is the most immediate and essential test to diagnose a myocardial infarction (MI) and assess the extent of heart damage. An ECG can quickly identify changes in the heart's electrical activity, allowing prompt initiation of appropriate interventions. A chest x-ray (Choice A) may show other conditions affecting the heart, but it is not the immediate test of choice for diagnosing an MI. An echocardiogram (Choice C) and coronary angiography (Choice D) are valuable in further assessing cardiac function and anatomy post-MI but are not the first-line diagnostic tests due to their time-consuming nature compared to an ECG.

5. The healthcare provider is evaluating the effects of care for a client with deep vein thrombosis (DVT). Which limb observations should the provider note as indicating the least success in meeting the outcome criteria for this problem?

• A. Pedal edema that is 3+
• B. Slight residual calf tenderness
• C. Skin warm, equal temperature in both legs
• D. Calf girth 1/8 inch larger than the unaffected limb

Correct answer: A

Rationale: Significant pedal edema, indicated by 3+, suggests ongoing or worsening venous insufficiency. This can be a sign that the care provided has not been effective in managing the deep vein thrombosis (DVT) and the associated complications. Monitoring and addressing pedal edema is crucial in the evaluation of DVT treatment outcomes and overall patient care. Choices B, C, and D are not indicative of the least success in meeting the outcome criteria for DVT. Slight residual calf tenderness, skin warmth, and a slightly larger calf girth do not necessarily point towards treatment failure or lack of improvement in DVT management.

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