Nursing Elites

1. A healthcare provider is caring for a client who has heart failure and is prescribed enalapril. The provider should monitor the client for which of the following adverse effects?

• A. Hypertension
• B. Hypokalemia
• C. Hyperglycemia
• D. Hyperkalemia

Correct answer: D

Rationale: Corrected Question: When a client with heart failure is prescribed enalapril, monitoring for hyperkalemia is essential. Enalapril is an angiotensin-converting enzyme (ACE) inhibitor that can lead to an increase in potassium levels in the blood. This adverse effect can be serious and potentially life-threatening. Choices A, B, and C are incorrect because enalapril does not typically cause hypertension, hypokalemia, or hyperglycemia as adverse effects. It's essential for healthcare providers to be vigilant in monitoring potassium levels when clients are on ACE inhibitors like enalapril.

2. How should a healthcare professional manage a patient with a chest tube?

• A. Ensuring the chest tube is secured properly and functioning
• B. Checking for air leaks and ensuring drainage is working
• C. Ensuring chest tube drainage is below chest level
• D. Ensuring proper documentation of chest tube output

Correct answer: D

Rationale: Proper documentation of chest tube output is crucial in the care of a patient with a chest tube. While ensuring the chest tube is secured and functioning, checking for air leaks, and maintaining drainage below chest level are important aspects of care, documentation of output is essential for monitoring the patient's condition, assessing the effectiveness of treatment, and ensuring appropriate interventions if needed.

3. A client has a prescription for vancomycin 1g IV intermittent infusion over 30 minutes every 12 hours. What action should the nurse take?

• A. Start the infusion immediately
• B. Slow down the infusion rate
• C. Contact the provider for prescription clarification
• D. Check blood pressure during the infusion

Correct answer: C

Rationale: The correct action for the nurse to take is to contact the provider for prescription clarification. Administering vancomycin over less than 60 minutes can lead to infusion reactions like hypotension and flushing. Starting the infusion immediately (choice A) is incorrect as it goes against the prescribed rate. Slowing down the infusion rate (choice B) without provider approval can result in underdosing the medication. Checking blood pressure during the infusion (choice D) is important but not the most immediate action needed in this situation.

4. A client with hyperthyroidism is prescribed propranolol. Which finding indicates that the propranolol is effective?

• A. The client reports an increase in weight
• B. The client has a decrease in blood pressure
• C. The client reports an increase in energy
• D. The client's respiratory rate has increased

Correct answer: B

Rationale: The correct answer is B because a decrease in blood pressure is an expected outcome when propranolol, a beta-blocker, is effectively managing hyperthyroidism. Propranolol helps control symptoms such as tachycardia and hypertension associated with hyperthyroidism. Choices A, C, and D are incorrect because weight gain, increased energy, and an increased respiratory rate are not direct indicators of propranolol's effectiveness in treating hyperthyroidism.

5. A nurse is caring for a client who has an ethical conflict about the care she is receiving. Which of the following resources should the nurse consult about resolving the dilemma?

• A. Hospital ethics committee
• B. Quality improvement committee
• C. Chaplain
• D. Director of nursing

Correct answer: A

Rationale: The correct answer is the hospital ethics committee. This committee is specifically designed to address and resolve ethical conflicts in patient care. It comprises professionals from various disciplines who can provide guidance and support in navigating ethical dilemmas. Choice B, the quality improvement committee, focuses on enhancing the quality of care provided but may not be equipped to handle ethical conflicts. Choice C, the chaplain, offers spiritual and emotional support but may not have the expertise to resolve ethical dilemmas. Choice D, the director of nursing, is responsible for nursing operations and may not be the appropriate resource for addressing ethical conflicts.

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