Nursing Elites

1. A nurse is reviewing the medical record of a client who has a new prescription for enalapril. Which of the following findings should the nurse report to the provider?

• A. Serum potassium 4.0 mEq/L
• B. Sodium 138 mEq/L
• C. Serum creatinine 3.8 mg/dL
• D. Hemoglobin 13 g/dL

Correct answer: C

Rationale: The correct answer is C. An elevated serum creatinine level can indicate impaired kidney function, which is crucial to report before administering enalapril. Enalapril, an ACE inhibitor, can affect kidney function, especially in patients with pre-existing renal impairment. Choices A, B, and D are within normal ranges and do not directly impact the initiation of enalapril therapy.

2. A client with a new diagnosis of hypertension is receiving discharge teaching. Which statement by the client indicates an understanding of the teaching?

• A. I will take my medication only when I feel dizzy.
• B. I will check my blood pressure at least once a week.
• C. I will limit my saturated fat intake to 7% of daily calories.
• D. I will take my medication only when I have symptoms.

Correct answer: C

Rationale: The correct answer is C because limiting saturated fat intake to 7% of daily calories is a crucial component of the dietary management for hypertension. This dietary modification helps reduce the risk of cardiovascular complications. Choices A, B, and D are incorrect. Choice A is incorrect because medication adherence should not be based on symptoms like dizziness. Choice B is inadequate as blood pressure monitoring should be more frequent, preferably daily, for effective management of hypertension. Choice D is incorrect because medication for hypertension should be taken consistently as prescribed, not just when symptoms occur.

3. A nurse is planning care for a group of clients. Which of the following clients should the nurse plan to assess first?

• A. A client who has a fractured femur and reports feeling short of breath.
• B. A client who is postoperative and has abdominal distention.
• C. A client who is receiving IV fluids and has a temperature of 38.5°C (101.3°F).
• D. A client who has cancer and has been receiving radiation therapy.

Correct answer: A

Rationale: The correct answer is A. A client with a fractured femur and reports feeling short of breath is at risk for a fat embolism, which is a medical emergency. The nurse should assess this client first to rule out this serious complication. Choice B may indicate paralytic ileus, which is important but not immediately life-threatening compared to a fat embolism. Choice C has a fever, which indicates infection but is not as urgent as a potential fat embolism. Choice D, a client receiving radiation therapy, is not experiencing an acute, life-threatening complication that requires immediate assessment compared to a fat embolism.

4. A nurse is providing teaching to a client who has diabetes mellitus and a new prescription for insulin glargine. Which of the following instructions should the nurse include?

• A. You should inject this medication once a day, at the same time each day.
• B. You should expect your blood glucose level to increase immediately after administration.
• C. You should rotate injection sites between your abdomen and thigh.
• D. You should inject this medication with your meals.

Correct answer: A

Rationale: The correct instruction that the nurse should include is to inject insulin glargine once a day, at the same time each day. Insulin glargine is a long-acting insulin that provides a consistent level of insulin over 24 hours, helping to maintain stable blood glucose levels. Option B is incorrect because insulin glargine does not cause an immediate increase in blood glucose levels. Option C is important for preventing lipodystrophy but is not specific to insulin glargine administration. Option D is incorrect because insulin glargine is typically administered at the same time each day, regardless of meals.

5. A nurse is providing teaching to a client who has a new diagnosis of osteoporosis and is prescribed alendronate. Which of the following instructions should the nurse include?

• A. Take this medication with food.
• B. Take this medication with a full glass of water after meals.
• C. Take this medication on an empty stomach with a full glass of water.
• D. You can take this medication at any time of day.

Correct answer: C

Rationale: Correct Answer: C. Alendronate should be taken on an empty stomach with a full glass of water to ensure proper absorption. Choice A is incorrect because alendronate should not be taken with food. Choice B is incorrect because alendronate should be taken on an empty stomach, not after meals. Choice D is incorrect because alendronate should be taken at a specific time following the instructions given.

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