Nursing Elites

1. A client with chronic kidney disease is being educated by a nurse about managing their condition. Which of the following statements shows an understanding of the teaching?

• A. I will need to take an iron supplement.
• B. I will consume foods high in phosphorus.
• C. I will reduce my intake of carbohydrates.
• D. I will monitor my blood glucose level daily.

Correct answer: A

Rationale: The correct answer is A. Clients with chronic kidney disease often develop anemia due to reduced erythropoietin production, leading to decreased red blood cell production. Iron supplementation is frequently required to enhance red blood cell production. Choices B, C, and D are incorrect because in chronic kidney disease, there is a need to restrict phosphorus intake, control carbohydrate intake for blood sugar management, and monitor electrolytes and fluid balance rather than blood glucose levels.

2. A nurse is assessing a client with suspected myocardial infarction. Which finding supports this diagnosis?

• A. Pain radiating to the left arm
• B. Pain relieved by rest
• C. Pain worsening with deep breathing
• D. Pain relieved by antacids

Correct answer: A

Rationale: The correct answer is A. Pain radiating to the left arm is a classic symptom of myocardial infarction, commonly known as a heart attack. This occurs due to the referred pain pathways shared by the heart and the left arm. Choices B, C, and D are incorrect. Pain relieved by rest (choice B) is more indicative of musculoskeletal pain rather than cardiac-related pain. Pain worsening with deep breathing (choice C) is often seen in conditions like pleurisy or pulmonary embolism, not myocardial infarction. Pain relieved by antacids (choice D) suggests gastrointestinal issues like heartburn or acid reflux, not cardiac-related pain.

3. When educating a client about valproic acid, which instruction is essential?

• A. Monitor for rash
• B. Expect weight loss
• C. Consider it safe during pregnancy
• D. Purchase it over-the-counter

Correct answer: A

Rationale: The correct answer is to instruct the client to monitor for rash. Valproic acid can lead to severe skin rashes, and patients must be vigilant to report any rash promptly. Choice B is incorrect as valproic acid is more likely to cause weight gain. Choice C is incorrect because valproic acid is associated with birth defects and should be avoided during pregnancy. Choice D is incorrect as valproic acid is a prescription medication and not available over-the-counter.

4. A nurse is caring for a client with a new prescription for atorvastatin. Which of the following should the nurse monitor?

• A. Liver function tests
• B. Potassium levels
• C. Blood glucose levels
• D. Serum calcium levels

Correct answer: A

Rationale: The correct answer is A: Liver function tests. Atorvastatin, a medication commonly used to lower cholesterol levels, can potentially cause liver damage as a side effect. Monitoring liver function tests is essential to detect any abnormalities early. Choices B, C, and D are incorrect because atorvastatin is not known to directly impact potassium levels, blood glucose levels, or serum calcium levels. While these parameters may be monitored for other reasons, the priority when administering atorvastatin is to monitor liver function due to the risk of hepatotoxicity.

5. A client is recovering from an acute myocardial infarction. Which of the following interventions should the nurse include in the plan of care?

• A. Draw a troponin level every four hours
• B. Perform an EKG every 12 hours
• C. Plan for oxygen therapy with a rebreather mask
• D. Obtain a cardiac rehabilitation consult

Correct answer: D

Rationale: The correct answer is to obtain a cardiac rehabilitation consult. Cardiac rehabilitation is an essential part of the care plan for a client recovering from a myocardial infarction. It helps in improving recovery, enhancing quality of life, and reducing the risk of future cardiac events. Drawing troponin levels and performing EKGs are important for diagnosing and monitoring myocardial infarctions but are not interventions in the post-MI care plan. Oxygen therapy may be necessary based on the client's condition but is not specific to post-MI care.

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