Nursing Elites

1. A client has a new prescription for metformin. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Monitor for signs of hypoglycemia.
• C. Increase fluid intake.
• D. Expect a metallic taste in the mouth.

Correct answer: C

Rationale: The correct instruction for a client starting metformin is to increase fluid intake. This is crucial to prevent gastrointestinal discomfort, a common side effect of metformin. Adequate hydration can also help reduce the risk of kidney problems associated with metformin use. Choices A, B, and D are incorrect. While it's generally recommended to take metformin with food to reduce stomach upset, monitoring for signs of hypoglycemia is more relevant for other antidiabetic medications, and a metallic taste in the mouth is not a common side effect of metformin.

2. When providing teaching to a client with a new prescription for atorvastatin, which of the following instructions should the nurse include?

• A. Take the medication in the evening.
• B. Take the medication with food.
• C. Increase your intake of grapefruit juice.
• D. Avoid consuming dairy products.

Correct answer: A

Rationale: The correct instruction for a client with a new prescription for atorvastatin is to take the medication in the evening. Atorvastatin is more effective when taken at night because cholesterol synthesis is higher during this time. This timing helps optimize the drug's cholesterol-lowering effects and enhances its overall efficacy in managing lipid levels. Choices B, C, and D are incorrect. Taking atorvastatin with food can decrease its absorption, grapefruit juice can interact with atorvastatin leading to increased side effects, and there is no specific need to avoid dairy products while on atorvastatin unless instructed otherwise by the healthcare provider.

3. What should be the nurse's priority action when a client diagnosed with angina pectoris complains of chest pain while taking a brisk walk?

• A. Administer nitroglycerin
• B. Have the client sit down
• C. Obtain an electrocardiogram
• D. Apply oxygen

Correct answer: B

Rationale: The nurse's priority action when a client diagnosed with angina pectoris complains of chest pain while taking a brisk walk is to have the client sit down. Sitting down reduces the workload on the heart and may alleviate pain by improving oxygen supply. This action aims to reduce the strain on the heart and improve oxygen delivery to the myocardium, which can help relieve the symptoms of angina pectoris. Administering nitroglycerin could be the next step after having the client sit down if the pain persists. Obtaining an electrocardiogram and applying oxygen are not the immediate priority actions when dealing with angina pectoris symptoms.

4. A client who had a myocardial infarction (MI) two days ago reports chest pain radiating to the left arm. What should the nurse do immediately?

• A. Administer morphine
• B. Obtain an electrocardiogram (ECG)
• C. Apply oxygen via nasal cannula
• D. Administer sublingual nitroglycerin

Correct answer: B

Rationale: Obtaining an ECG is crucial in this situation because it helps in assessing for potential complications, such as a recurrent MI or ongoing ischemia. This diagnostic test provides valuable information to guide further interventions and treatment. Administering morphine, oxygen, or nitroglycerin may be necessary but obtaining an ECG takes precedence to evaluate the cardiac status and determine the appropriate course of action. Administering morphine without assessing the current cardiac status through an ECG can mask important diagnostic clues. Applying oxygen and administering nitroglycerin are supportive measures that can follow the ECG to address potential hypoxia and ischemic pain relief, respectively.

5. A client with a history of hypertension is being discharged on a low-sodium diet. Which statement by the client indicates a need for further teaching?

• A. I will use fresh herbs and spices instead of salt.
• B. I will avoid canned soups and processed foods.
• C. I can eat as much bacon and sausage as I want because they taste good.
• D. I will read food labels to check for sodium content.

Correct answer: C

Rationale: Choice C is the correct answer because bacon and sausage are high in sodium, which contradicts the low-sodium diet requirement. Consuming them freely would contribute to increased sodium intake, which is not suitable for managing hypertension. Choices A, B, and D demonstrate appropriate understanding and actions for a low-sodium diet, such as using alternatives to salt, avoiding processed foods, and checking food labels for sodium content.

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