Nursing Elites

1. 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.

2. The healthcare provider is preparing to assist in the care of a client who has just returned from coronary artery bypass graft (CABG) surgery. Which is the priority action?

• A. Monitor the client's urine output.
• B. Check the client's surgical dressing.
• C. Measure the client's blood pressure.
• D. Assess the client's level of consciousness.

Correct answer: D

Rationale: Assessing the client's level of consciousness is the priority action post-CABG surgery to monitor for signs of cerebral hypoxia or other complications that require immediate intervention. Changes in the client's level of consciousness can indicate neurological deterioration, which is critical to address promptly in this postoperative period. Monitoring urine output, checking surgical dressing, and measuring blood pressure are important aspects of postoperative care but assessing the client's level of consciousness takes precedence as it provides crucial information about the client's neurological status and the need for urgent intervention.

3. A healthcare provider is providing discharge instructions to a client who has a new prescription for warfarin. Which of the following statements should the healthcare provider include?

• A. Avoid using a soft toothbrush.
• B. Report any signs of bleeding.
• C. Increase your intake of leafy green vegetables.
• D. Take the medication with food.

Correct answer: B

Rationale: The correct answer is to instruct the client to report any signs of bleeding when taking warfarin. Warfarin is an anticoagulant medication that increases the risk of bleeding, so it is essential to monitor for any signs of abnormal bleeding and report them promptly for appropriate management. Choices A, C, and D are incorrect. Instructing the client to avoid using a soft toothbrush is not directly related to warfarin therapy. Increasing the intake of leafy green vegetables is not recommended as they contain vitamin K, which can interfere with warfarin's anticoagulant effects. Taking warfarin with food can be inconsistent and may not result in optimal absorption.

4. A client has a new prescription for docusate sodium. Which of the following instructions should be included in the discharge teaching?

• A. Take the medication with a full glass of water.
• B. Take the medication at bedtime.
• C. Take the medication on an empty stomach.
• D. Avoid taking the medication with antacids.

Correct answer: A

Rationale: Corrected Rationale: When taking docusate sodium, it is important to take the medication with a full glass of water to help ensure its proper effectiveness. This helps prevent the stool from hardening and makes it easier to pass, especially for individuals experiencing constipation. Choice B is incorrect because there is no specific instruction to take docusate sodium at bedtime. Choice C is incorrect because docusate sodium does not need to be taken on an empty stomach. Choice D is incorrect because there is no need to avoid taking docusate sodium with antacids.

5. A client with a diagnosis of angina pectoris is prescribed nitroglycerin tablets. How should the nurse instruct the client to take the medication?

• A. Swallow the tablet whole with water
• B. Place the tablet under the tongue and let it dissolve
• C. Chew the tablet and then swallow
• D. Place the tablet between the cheek and gum

Correct answer: B

Rationale: Nitroglycerin is most effective when administered sublingually (under the tongue) as it is rapidly absorbed into the bloodstream. Placing the tablet under the tongue allows for quick absorption and faster relief of angina symptoms. Chewing the tablet, swallowing it, or placing it between the cheek and gum would not provide the same rapid onset of action needed during an angina episode. Therefore, the correct instruction for the client is to place the nitroglycerin tablet under the tongue and let it dissolve for optimal effectiveness.

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