Nursing Elites

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

• A. Weight gain
• B. Increased heart rate
• C. Heat intolerance
• D. Elevated blood pressure

Correct answer: C

Rationale: The correct answer is C: Heat intolerance. Heat intolerance is a concerning sign of levothyroxine toxicity and should be reported to the provider promptly. Levothyroxine is a medication used to treat hypothyroidism by supplementing the body's thyroid hormones. When a client experiences heat intolerance, it can indicate that the dose of levothyroxine is too high, leading to hyperthyroidism symptoms. Weight gain, increased heart rate, and elevated blood pressure are not typically associated with levothyroxine toxicity; instead, they are more commonly seen in conditions like hypothyroidism.

2. The healthcare provider has reinforced dietary instructions to a client with coronary artery disease. Which statement by the client indicates an understanding of the dietary instructions?

• A. I should substitute eggs and milk for meat.
• B. I will eliminate all cholesterol and fat from my diet.
• C. I should routinely use polyunsaturated oils in my diet.
• D. I need to consider becoming a strict vegetarian.

Correct answer: C

Rationale: The correct answer is C. Using polyunsaturated oils, such as vegetable oils, can help manage cholesterol levels and reduce the risk of heart disease. This dietary change is beneficial for individuals with coronary artery disease as it promotes heart health by improving cholesterol profiles. Substituting eggs and milk for meat (Choice A) may not address the overall dietary needs for managing the condition. Completely eliminating all cholesterol and fat from the diet (Choice B) is not necessary as the body needs some healthy fats. Considering becoming a strict vegetarian (Choice D) is a personal choice and may not necessarily be required to manage coronary artery disease.

3. A client with a diagnosis of angina pectoris returns to the nursing unit after experiencing an angioplasty. The nurse reinforces instructions to the client regarding the procedure and home care measures. Which statement by the client indicates an understanding of the instructions?

• A. I am considering cutting my workload.
• B. I need to cut down on cigarette smoking.
• C. I am so relieved that my heart is repaired.
• D. I need to adhere to my dietary restrictions.

Correct answer: D

Rationale: The correct answer is D because adhering to dietary restrictions is crucial in managing heart health post-angioplasty. Choice A focuses on workload, choice B mentions smoking, and choice C reflects relief about heart repair, which are important but do not directly relate to post-angioplasty care instructions.

4. An ambulatory clinic nurse is interviewing a client who is complaining of flu-like symptoms. The client suddenly develops chest pain. Which question best assists the nurse in discriminating pain caused by a non-cardiac problem?

• A. Can you describe the pain to me?
• B. Have you ever experienced this pain before?
• C. Does the pain get worse when you breathe in?
• D. Can you rate the pain on a scale of 1 to 10, with 10 being the worst?

Correct answer: C

Rationale: The correct answer is C. Pain that worsens with breathing in can indicate pleuritic chest pain, which is non-cardiac in nature. This specific question helps in differentiating non-cardiac causes from cardiac causes of chest pain, as cardiac pain typically does not worsen with breathing. Choices A, B, and D are less specific in discriminating between cardiac and non-cardiac chest pain.

5. The healthcare provider is reinforcing teaching for a client who is starting statin therapy. Which dietary advice should the healthcare provider give?

• A. Eat more whole grains.
• B. Avoid foods high in potassium.
• C. Avoid grapefruit and grapefruit juice.
• D. Increase intake of dairy products.

Correct answer: C

Rationale: The correct answer is C: Avoid grapefruit and grapefruit juice. Grapefruit and grapefruit juice can interfere with the metabolism of statins, leading to an increased risk of adverse effects. It is crucial for clients on statin therapy to avoid grapefruit products to ensure the medication's effectiveness and safety. Choices A, B, and D are incorrect because they do not directly impact the metabolism or effectiveness of statin therapy.

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