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. A nurse is providing discharge teaching to a client following a myocardial infarction (MI). Which of the following activities should the client avoid?

• A. Swimming in a pool
• B. Driving a car
• C. Light housework
• D. Walking on flat ground

Correct answer: B

Rationale: The correct answer is B: Driving a car. Driving a car can be physically and emotionally taxing, increasing the risk of complications soon after a myocardial infarction. It requires quick reflexes and decision-making abilities, which may be impaired during the recovery period. Swimming in a pool, light housework, and walking on flat ground are generally safe and beneficial activities for clients following a myocardial infarction as they promote circulation, muscle strength, and overall well-being.

3. A client who reports insomnia is being taught by a nurse about promoting rest and sleep. Which statement should indicate to the nurse that the client understands the instructions?

• A. I will walk briskly for 30 minutes before bedtime
• B. I will have a cup of hot cocoa immediately before bedtime
• C. I will no longer have a glass of wine before bedtime
• D. I will do my muscle relaxation techniques each afternoon

Correct answer: C

Rationale: The correct answer is C because avoiding alcohol before bedtime can help promote better sleep. Choice A is incorrect as vigorous exercise close to bedtime can actually hinder sleep. Choice B is also incorrect as consuming beverages with caffeine or sugar close to bedtime can disrupt sleep. Choice D, while a good practice, does not directly address the issue of avoiding alcohol before bedtime to improve sleep quality.

4. A healthcare provider is preparing to administer digoxin to a patient with heart failure. Which of the following lab results should be reviewed before administering the medication?

• A. Potassium level
• B. Calcium level
• C. Hemoglobin level
• D. White blood cell count

Correct answer: A

Rationale: The correct answer is A: Potassium level. Hypokalemia increases the risk of digoxin toxicity. Digoxin can potentiate the effects of low potassium levels, leading to life-threatening arrhythmias. Therefore, it is essential to review the patient's potassium level before administering digoxin. Choices B, C, and D are incorrect because calcium level, hemoglobin level, and white blood cell count are not directly related to the risk of digoxin toxicity.

5. When educating a patient with hypertension about lifestyle changes, what is the most crucial advice to provide?

• A. Advise the patient to reduce salt intake.
• B. Instruct the patient to limit alcohol consumption.
• C. Recommend the patient to exercise for 30 minutes every day.
• D. Instruct the patient to avoid high-cholesterol foods.

Correct answer: A

Rationale: The most critical lifestyle change for a patient with hypertension is to reduce salt intake. Excessive salt consumption can lead to increased blood pressure levels. While limiting alcohol consumption (Choice B) and regular exercise (Choice C) are also beneficial for managing hypertension, reducing salt intake has a more direct impact on blood pressure control. Avoiding high-cholesterol foods (Choice D) is important for heart health but may not have as significant an impact on blood pressure as reducing salt intake.

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