Nursing Elites

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

• A. Blood pressure of 150/80 mm Hg
• B. Swelling in the legs
• C. Persistent cough
• D. Heart rate of 72 beats per minute

Correct answer: C

Rationale: The correct answer is C: Persistent cough. Enalapril is known to cause a persistent dry cough as a side effect. This adverse reaction is due to the accumulation of bradykinin in the lungs, leading to irritation and cough. The nurse should report this symptom to the provider for further evaluation and possible medication adjustment. Choices A, B, and D are not directly associated with enalapril use. While a blood pressure of 150/80 mm Hg is elevated and should be monitored, it is not a direct side effect of enalapril. Swelling in the legs and a heart rate of 72 beats per minute are also not typically related to enalapril use and should be assessed but are not the priority findings to report in this scenario.

2. How should a healthcare professional care for a patient with a central venous catheter?

• A. Monitor for infection and change the dressing regularly
• B. Ensure the catheter is patent and flush as needed
• C. Educate the patient on self-care and proper hygiene
• D. Monitor blood glucose levels and administer IV fluids

Correct answer: A

Rationale: Corrected Rationale: Regular monitoring for infection and dressing changes are essential aspects of caring for a patient with a central venous catheter. Infections are a significant risk with these catheters, so vigilant monitoring and timely dressing changes help prevent complications. Choice B is important too, but ensuring catheter patency and flushing are more focused on maintaining the functionality of the catheter rather than infection prevention. Choice C is also important for patient education, but the immediate concern for a healthcare professional is monitoring and preventing infections related to the catheter. Choice D is not directly related to the care of a central venous catheter.

3. What should a healthcare provider prioritize for a client diagnosed with bipolar disorder?

• A. Monitor for hyperactivity
• B. Monitor for signs of depression
• C. Monitor for changes in self-esteem
• D. Monitor for changes in energy levels

Correct answer: B

Rationale: When caring for a client diagnosed with bipolar disorder, the priority is to monitor for signs of depression. Individuals with bipolar disorder are at risk of severe depressive episodes, making it crucial to watch for signs of depression. While changes in energy levels and self-esteem are common in bipolar disorder, they are not the primary focus. Hyperactivity is a characteristic of the manic phase of bipolar disorder, so monitoring for depression is the priority in this case.

4. A nurse is caring for a client who has diabetes mellitus and is receiving insulin. Which of the following findings should the nurse report to the provider?

• A. A fasting blood glucose of 90 mg/dL
• B. A blood glucose level of 200 mg/dL
• C. A hemoglobin A1c of 6%
• D. A fasting blood glucose of 100 mg/dL

Correct answer: B

Rationale: The correct answer is B. A blood glucose level of 200 mg/dL indicates hyperglycemia, which may necessitate insulin adjustment to better control the client's blood sugar levels. A fasting blood glucose of 90 mg/dL (choice A) is within the normal range, a hemoglobin A1c of 6% (choice C) is indicative of good long-term blood sugar control, and a fasting blood glucose of 100 mg/dL (choice D) is also within the normal range. Therefore, these findings do not require immediate reporting to the provider.

5. What are the signs of an acute myocardial infarction?

• A. Chest pain radiating to the arm and shortness of breath
• B. Nausea, vomiting, and high fever
• C. Headache, confusion, and low blood pressure
• D. Increased heart rate and bradycardia

Correct answer: A

Rationale: The correct answer is A: Chest pain radiating to the arm and shortness of breath. These are classic signs of an acute myocardial infarction. Choice B is incorrect because nausea, vomiting, and high fever are not typical signs of a heart attack. Choice C is incorrect as headache, confusion, and low blood pressure are not specific to myocardial infarction. Choice D is incorrect because an acute myocardial infarction typically presents with an increased heart rate, not bradycardia.

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