Nursing Elites

1. The client with angina is being discharged to home. The nurse is instructing the client on dietary changes. What should be included in this teaching?

• A. Decrease salt and fat intake and limit alcohol intake.
• B. There are no dietary restrictions for a person diagnosed with angina.
• C. Limit smoking and increase protein and sugar intake.
• D. Increase fruits, vegetables, and foods high in cholesterol.

Correct answer: A

Rationale: The correct answer is to decrease salt and fat intake and limit alcohol intake. These dietary changes can help manage angina by reducing the workload on the heart and preventing further plaque buildup in the arteries. Choices B, C, and D are incorrect as dietary restrictions for angina typically involve reducing salt, fat, and alcohol intake, rather than increasing sugar or cholesterol intake.

2. What is the expected outcome of Valproate therapy?

• A. Decreased fever
• B. Decreased sense of anxiety
• C. Decreased blood pressure
• D. Decreased seizure activity

Correct answer: D

Rationale: The correct answer is D: Decreased seizure activity. Valproate is commonly used in the treatment of epilepsy to help control and reduce seizure frequency. Choices A, B, and C are incorrect because Valproate is not primarily used to treat fever, anxiety, or blood pressure issues.

3. A client has a new prescription for a Nitroglycerin transdermal patch for Angina Pectoris. Which of the following instructions should the nurse include?

• A. Remove the patch each evening.
• B. Do not cut the patch in half even if angina attacks are under control.
• C. Take off the nitroglycerin patch if a headache occurs.
• D. Apply a new patch every 48 hours.

Correct answer: A

Rationale: The correct instruction is to remove the nitroglycerin patch each evening to prevent tolerance. This allows for a 10- to 12-hour nitrate-free period daily, reducing the risk of developing tolerance to nitroglycerin. Cutting the patch in half is not recommended because it can alter the dosing and absorption rate, leading to inadequate symptom control. Taking off the patch for a headache is not necessary as headaches are a common side effect that may improve with continued use. Applying a new patch every 48 hours is not correct as it may not provide continuous symptom relief for angina.

4. A healthcare provider is providing discharge instructions to a client who is prescribed Enalapril. Which of the following adverse effects should the healthcare provider instruct the client to monitor?

• A. Dry cough
• B. Weight gain
• C. Diarrhea
• D. Nausea

Correct answer: A

Rationale: A persistent dry cough is a common adverse effect of Enalapril, an ACE inhibitor. This cough is a result of increased bradykinin levels due to ACE inhibition. The client should be educated to monitor for a dry cough and notify the healthcare provider if it occurs, as it may indicate the need for a medication adjustment. Choices B, C, and D are incorrect because weight gain, diarrhea, and nausea are not commonly associated adverse effects of Enalapril.

5. A client has a new prescription for nitroglycerin. Which of the following adverse effects should the nurse instruct the client to report that can indicate the medication is effective?

• A. Headache
• B. Nausea
• C. Dizziness
• D. Dry mouth

Correct answer: A

Rationale: Headache is a common side effect of nitroglycerin due to its vasodilatory effects. It can indicate that the medication is working effectively by dilating blood vessels, improving blood flow, and reducing cardiac workload. Therefore, the client should report experiencing headaches as it may suggest the therapeutic action of nitroglycerin. Nausea, dizziness, and dry mouth are not typically associated with the therapeutic effects of nitroglycerin and should be reported as adverse effects that may necessitate medical attention.

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