Nursing Elites

1. A client has a new prescription for alendronate. Which of the following instructions should be included in the teaching?

• A. Take the medication with a full glass of water.
• B. Lie down for 30 minutes after taking the medication.
• C. Take the medication at bedtime.
• D. Avoid dairy products while taking the medication.

Correct answer: A

Rationale: The correct instruction for taking alendronate is to take it with a full glass of water to prevent esophageal irritation. This helps ensure proper absorption and reduces the risk of irritation to the esophagus. Choice B is incorrect because patients should remain upright for at least 30 minutes after taking alendronate to prevent esophageal irritation. Choice C is incorrect as alendronate should be taken in the morning on an empty stomach. Choice D is also incorrect as there is no specific requirement to avoid dairy products while taking alendronate.

2. A client is receiving morphine for pain. Which of the following assessments is the priority?

• A. Urine output
• B. Pupil reaction
• C. Respiratory rate
• D. Bowel sounds

Correct answer: C

Rationale: The correct answer is C: Respiratory rate. Monitoring the respiratory rate is the priority assessment for a client receiving morphine due to the risk of respiratory depression. Morphine is a potent opioid that can cause respiratory depression, which is a serious adverse effect that can be life-threatening. Assessing the client's respiratory rate is crucial to detect any signs of respiratory depression early and intervene promptly. Assessing urine output is important but not as critical as monitoring for respiratory depression with morphine. Pupil reaction and bowel sounds are also important assessments but do not take precedence over monitoring the respiratory rate when a client is on morphine.

3. The healthcare provider is teaching a client with hypertension about lifestyle modifications. Which recommendation should the healthcare provider include?

• A. Limit alcohol consumption to one drink per day.
• B. Increase sodium intake to maintain blood pressure.
• C. Exercise vigorously for at least 30 minutes daily.
• D. Avoid high potassium foods like bananas.

Correct answer: A

Rationale: Limiting alcohol intake is an essential lifestyle modification recommended for managing hypertension. Excessive alcohol consumption can raise blood pressure, so limiting it to one drink per day is beneficial in controlling hypertension. Alcohol moderation is a key part of a heart-healthy lifestyle for individuals with high blood pressure. Choice B is incorrect because increasing sodium intake can actually worsen hypertension by retaining water and increasing blood pressure. Choice C is incorrect because while exercise is important for overall health, moderate-intensity exercise is recommended for individuals with hypertension to avoid excessive strain on the heart. Choice D is incorrect because high potassium foods like bananas are actually beneficial for individuals with hypertension as they can help lower blood pressure.

4. A client with a history of angina is scheduled for an exercise electrocardiography (ECG) test. The nurse should explain that the purpose of this test is to evaluate which factor?

• A. The heart's response to physical stress
• B. The client's overall physical fitness
• C. The presence of electrolyte imbalances
• D. The effectiveness of anti-anginal medications

Correct answer: A

Rationale: An exercise electrocardiography (ECG) test is used to evaluate the heart's response to physical stress. During the test, the heart's electrical activity is monitored while the client exercises, helping to identify any areas of ischemia or abnormal rhythms. This test helps healthcare providers assess the heart's function and detect any potential issues related to angina or other cardiac conditions. Choice B, the client's overall physical fitness, is incorrect because the test primarily focuses on the heart's response to stress rather than the client's general physical fitness. Choice C, the presence of electrolyte imbalances, is incorrect as this test is not specifically designed to evaluate electrolyte levels. Choice D, the effectiveness of anti-anginal medications, is incorrect as the main purpose of the test is to assess the heart's response to physical stress, not medication effectiveness.

5. A client has a history of left-sided heart failure. The nurse should look for the presence of which finding to determine whether the problem is currently active?

• A. Presence of ascites
• B. Bilateral lung crackles
• C. Jugular vein distention
• D. Pedal edema bilaterally

Correct answer: B

Rationale: When assessing a client with a history of left-sided heart failure, the presence of bilateral lung crackles is a key finding to determine if the condition is currently active. Crackles in the lungs indicate fluid accumulation, a common sign of left-sided heart failure due to pulmonary congestion. Choices A, C, and D are incorrect because ascites, jugular vein distention, and pedal edema are more commonly associated with right-sided heart failure.

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