Nursing Elites

1. A nurse is assessing a client who has a new prescription for enalapril. Which of the following findings is a priority for the nurse to report to the provider?

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

Correct answer: D

Rationale: The correct answer is D: Dizziness. Dizziness is a sign of hypotension, a potential adverse effect of enalapril. Enalapril is an ACE inhibitor commonly prescribed for hypertension. Hypotension is a serious side effect that can lead to complications such as falls and injuries. Reporting dizziness promptly is crucial to prevent any harm to the client. Choices A, B, and C are not directly associated with enalapril use and are less concerning compared to the potential implications of hypotension indicated by dizziness.

2. When providing teaching to a client with a new prescription for atorvastatin, which of the following instructions should the nurse include?

• A. Take the medication in the evening.
• B. Take the medication with food.
• C. Increase your intake of grapefruit juice.
• D. Avoid consuming dairy products.

Correct answer: A

Rationale: The correct instruction for a client with a new prescription for atorvastatin is to take the medication in the evening. Atorvastatin is more effective when taken at night because cholesterol synthesis is higher during this time. This timing helps optimize the drug's cholesterol-lowering effects and enhances its overall efficacy in managing lipid levels. Choices B, C, and D are incorrect. Taking atorvastatin with food can decrease its absorption, grapefruit juice can interact with atorvastatin leading to increased side effects, and there is no specific need to avoid dairy products while on atorvastatin unless instructed otherwise by the healthcare provider.

3. A 24-year-old man seeks medical attention for complaints of claudication in the arch of the foot. The nurse also notes superficial thrombophlebitis of the lower leg. What should the nurse check the client for next?

• A. Smoking history
• B. Recent exposure to allergens
• C. History of recent insect bites
• D. Familial tendency toward peripheral vascular disease

Correct answer: A

Rationale: In this case, the nurse should check the client's smoking history next. Smoking is a significant risk factor for peripheral vascular disease, leading to the development of thrombophlebitis and claudication. It is important to assess this risk factor as it can significantly impact the client's vascular health and the progression of their current symptoms. Choices B, C, and D are incorrect because they are not directly related to the symptoms described by the client. Recent exposure to allergens or insect bites would typically present with different symptoms, and familial tendency toward peripheral vascular disease is not the immediate concern in this case.

4. The client is receiving furosemide (Lasix) for heart failure. What potential side effect should the nurse monitor for?

• A. Hypokalemia
• B. Hyperkalemia
• C. Hypernatremia
• D. Hypoglycemia

Correct answer: A

Rationale: The correct answer is A: Hypokalemia. Furosemide, a loop diuretic, causes potassium loss, leading to hypokalemia. Monitoring potassium levels is crucial because hypokalemia can result in cardiac arrhythmias and muscle weakness. Choices B, C, and D are incorrect because furosemide does not typically cause hyperkalemia, hypernatremia, or hypoglycemia.

5. The healthcare provider is monitoring a client with chronic stable angina. Which symptom would indicate that the client's condition is worsening?

• A. Increased shortness of breath with exertion
• B. Improved tolerance to activity
• C. Decreased frequency of chest pain
• D. Stable blood pressure readings

Correct answer: A

Rationale: Increased shortness of breath with exertion is a concerning symptom in a client with chronic stable angina as it may indicate inadequate oxygen supply to the heart muscle, suggesting a worsening condition. This could be a sign of reduced blood flow to the heart, leading to increased work for the heart during exertion, resulting in increased shortness of breath. Choice B, improved tolerance to activity, is incorrect as it would indicate a positive response to treatment. Choice C, decreased frequency of chest pain, is incorrect as it would also suggest an improvement in the client's condition. Choice D, stable blood pressure readings, are not indicative of a worsening condition in chronic stable angina.

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