Nursing Elites

1. A client with a history of angina reports substernal chest pain that radiates to the left arm. Which of the following actions should the nurse take first?

• A. Administer nitroglycerin sublingually.
• B. Administer 2L of oxygen via nasal cannula.
• C. Administer aspirin 325 mg orally.
• D. Obtain a 12-lead ECG.

Correct answer: D

Rationale: In a client with a history of angina experiencing chest pain radiating to the left arm, obtaining a 12-lead ECG is the priority action to assess for myocardial infarction. An ECG helps in diagnosing and evaluating the extent of cardiac ischemia or infarction. Administering nitroglycerin, oxygen, or aspirin can follow once the ECG has been performed to confirm the diagnosis and guide further interventions. Administering nitroglycerin sublingually is often appropriate for angina but should not precede the ECG in this urgent scenario. Oxygen therapy and aspirin administration are important interventions but obtaining the ECG takes precedence in assessing for acute cardiac events.

2. A nurse is providing teaching to a client with asthma. Which of the following client statements indicates a need for further teaching?

• A. I should use my albuterol inhaler before I exercise.
• B. I should avoid using my inhaler more than twice a week.
• C. I should take my inhaler only when I feel short of breath.
• D. I should rinse my mouth after using my corticosteroid inhaler.

Correct answer: C

Rationale: The correct answer is C because the client stating they should only take the inhaler when feeling short of breath indicates a need for further teaching. Clients with asthma should use their inhaler as prescribed, not just when short of breath. Choices A, B, and D demonstrate good asthma management practices. Choice A indicates understanding of using the albuterol inhaler before exercise to prevent exercise-induced symptoms. Choice B mentions the importance of not overusing the inhaler, which can indicate poor asthma control. Choice D shows awareness of rinsing the mouth after using a corticosteroid inhaler to prevent oral thrush.

3. A nurse is assessing a client who is in active labor. Which of the following findings should the nurse report to the provider?

• A. Contractions lasting 80 seconds.
• B. FHR baseline 170/min.
• C. Early decelerations in the FHR.
• D. Temperature 37.4°C (99.3°F).

Correct answer: B

Rationale: The correct answer is B. An FHR baseline of 170/min is considered tachycardia, which is above the normal range during labor and requires immediate attention. High FHR can indicate fetal distress or maternal fever. Choice A, contractions lasting 80 seconds, are within normal range for active labor. Choice C, early decelerations in the FHR, are usually benign and do not typically require immediate intervention. Choice D, a temperature of 37.4°C (99.3°F), is within normal limits.

4. A client with iron-deficiency anemia is being taught about dietary management by a nurse. Which of the following foods should the nurse recommend?

• A. Oatmeal
• B. Red meat
• C. Bananas
• D. Whole grains

Correct answer: B

Rationale: The correct answer is B: Red meat. Red meat is a good dietary source of heme iron, which is easily absorbed by the body and beneficial for individuals with iron-deficiency anemia. Oatmeal, bananas, and whole grains are not as rich in iron compared to red meat and may not provide sufficient amounts to help manage iron-deficiency anemia effectively.

5. A nurse is teaching a client who has a new prescription for alendronate. Which of the following client statements indicates an understanding of the teaching?

• A. I should take this medication at bedtime to prevent drowsiness.
• B. I should take this medication with a full glass of water before breakfast.
• C. I should avoid taking this medication with dairy products.
• D. I should remain upright for at least 30 minutes after taking this medication.

Correct answer: B

Rationale: The correct answer is B. Alendronate should be taken with a full glass of water before breakfast to prevent esophageal irritation and improve absorption. Choice A is incorrect as alendronate is not associated with causing drowsiness. Choice C is incorrect because alendronate can be taken with or without food, so avoiding dairy products is not necessary. Choice D is incorrect as the recommended time to remain upright after taking alendronate is 30 minutes to 1 hour, not just 30 minutes.

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