Nursing Elites

1. A nurse is providing discharge instructions to a client after a myocardial infarction. Which of the following should be included?

• A. Resume normal activities immediately
• B. Monitor for chest pain and report any recurrence
• C. Avoid all physical activity for 6 months
• D. Take medications only as needed

Correct answer: B

Rationale: The correct answer is B: 'Monitor for chest pain and report any recurrence.' After a myocardial infarction, it is crucial for clients to be vigilant about any signs of chest pain as it could indicate a recurrent event. Prompt reporting of chest pain can lead to timely intervention, preventing further complications. Choice A is incorrect because resuming normal activities immediately after a heart attack can be dangerous and is not recommended. Choice C is also incorrect as avoiding all physical activity for 6 months is excessive and can lead to deconditioning. Choice D is incorrect as medications prescribed after a myocardial infarction are usually meant to be taken regularly as prescribed, not just as needed.

2. When teaching a client about the use of lisinopril, which of the following should be included?

• A. It can cause a persistent cough
• B. It is a calcium channel blocker
• C. It is safe during pregnancy
• D. It should be taken with food

Correct answer: A

Rationale: The correct answer is A. Lisinopril is an ACE inhibitor, and a common side effect associated with its use is a persistent cough. This is important information that the client should be aware of. Choice B is incorrect because lisinopril is not a calcium channel blocker, it is an ACE inhibitor. Choice C is incorrect as lisinopril is not considered safe during pregnancy, especially during the second and third trimesters as it can cause harm to the fetus. Choice D is incorrect because lisinopril is typically recommended to be taken on an empty stomach, about an hour before meals.

3. A nurse on a rehab unit is creating a plan of care for a newly admitted patient who has difficulty swallowing following a stroke. Which interprofessional team members should the nurse anticipate consulting?

• A. Physical therapist
• B. Speech-language pathologist
• C. Social worker
• D. Respiratory therapist

Correct answer: B

Rationale: The correct answer is B: Speech-language pathologist. A speech-language pathologist specializes in assessing and treating swallowing disorders, making them the most appropriate consultant for a patient with difficulty swallowing following a stroke. While other interprofessional team members such as a physical therapist (choice A), social worker (choice C), and respiratory therapist (choice D) may play important roles in the patient's care, the primary focus for swallowing difficulties would be the speech-language pathologist.

4. A nurse is caring for a client who has been prescribed methadone. Which of the following client statements indicates a need for further teaching?

• A. I understand methadone slows my breathing.
• B. I understand methadone may cause me to have trouble sleeping.
• C. I will avoid alcohol while I’m taking this medication.
• D. I’ll change positions slowly, especially when standing.

Correct answer: B

Rationale: The correct answer is B because methadone typically causes sedation and respiratory depression, not trouble sleeping. The statement about trouble sleeping indicates a need for further teaching. Choices A, C, and D are incorrect because understanding that methadone slows breathing, avoiding alcohol while taking the medication, and changing positions slowly to prevent dizziness are all appropriate client statements when prescribed methadone.

5. A charge nurse is discussing the use of applying ice to a client’s injured knee with a newly licensed nurse. Which of the following is a benefit of this treatment?

• A. Systemic analgesic effect
• B. Increase in metabolism
• C. Decreased capillary permeability
• D. Vasodilation

Correct answer: C

Rationale: The correct answer is C: Decreased capillary permeability. Ice application helps decrease capillary permeability, which in turn reduces swelling and inflammation at the injury site. This vasoconstriction effect helps to limit the extent of the injury. Choices A, B, and D are incorrect. Applying ice locally does not produce a systemic analgesic effect but rather a localized numbing effect. It does not increase metabolism but rather slows down metabolic processes in the affected area. Additionally, ice application causes vasoconstriction, not vasodilation.

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