Nursing Elites

1. The healthcare professional is assisting in the care of a client diagnosed with deep vein thrombosis (DVT). Which instruction should be reinforced to prevent complications?

• A. Elevate the affected leg using pillows.
• B. Perform leg exercises while sitting.
• C. Wear snug compression stockings.
• D. Avoid applying ice packs to injuries.

Correct answer: A

Rationale: Elevating the affected leg using pillows is crucial in managing deep vein thrombosis (DVT) as it helps reduce swelling and promote venous return, thereby decreasing the risk of complications such as pulmonary embolism. This position aids in improving blood circulation and preventing blood clots from forming or worsening in the affected leg. Performing leg exercises while sitting might increase the risk of dislodging a blood clot. While snug compression stockings are beneficial, the primary focus should be on elevation. Avoiding ice packs on injuries is unrelated to DVT management.

2. The client with myocardial infarction should reduce intake of saturated fat and cholesterol. Which food items from the dietary menu would assist the nurse in helping the client comply with diet therapy?

• A. Cheeseburger, pan-fried potatoes, whole kernel corn, sherbet
• B. Pork chop, baked potato, cauliflower in cheese sauce, ice cream
• C. Baked haddock, steamed broccoli, herbed rice, sliced strawberries
• D. Spaghetti and sweet sausage in tomato sauce, vanilla pudding (with 4% milk)

Correct answer: C

Rationale: Option C, which includes baked haddock, steamed broccoli, herbed rice, and sliced strawberries, is the most appropriate choice for a client with myocardial infarction looking to reduce saturated fat and cholesterol intake. This meal is low in saturated fats and cholesterol, making it a heart-healthy option that aligns with the dietary recommendations for such clients. Choices A, B, and D contain foods high in saturated fats and cholesterol, which are not suitable for a client with myocardial infarction trying to adhere to a diet therapy aimed at reducing these components.

3. What preoperative instruction should the LPN/LVN reinforce to a client scheduled for a carotid endarterectomy?

• A. You will need to be NPO after midnight before the surgery.
• B. You should avoid deep breathing and coughing after the surgery.
• C. You will be able to eat and drink normally after the procedure.
• D. You can take all of your prescribed medications the morning of surgery.

Correct answer: A

Rationale: The correct preoperative instruction that the LPN/LVN should reinforce to a client scheduled for a carotid endarterectomy is being NPO after midnight before the surgery. This instruction is essential to prevent aspiration and ensure a safe procedure. Avoiding oral intake helps reduce the risk of complications during anesthesia induction and the surgical process. Choices B, C, and D are incorrect because avoiding deep breathing and coughing, resuming normal eating and drinking, and taking all prescribed medications the morning of surgery are not recommended preoperative instructions for a carotid endarterectomy.

4. A nurse is assessing a client who is taking amiodarone. Which of the following findings should the nurse report to the provider?

• A. Dry skin
• B. Weight loss
• C. Bradycardia
• D. Productive cough

Correct answer: D

Rationale: A productive cough can indicate pulmonary toxicity, a serious side effect of amiodarone, and should be reported. Dry skin is not typically associated with amiodarone use. Weight loss is a common side effect of amiodarone but not generally a cause for concern unless severe. Bradycardia is a known side effect of amiodarone and may not necessarily require immediate reporting unless symptomatic.

5. A client has a new prescription for nitroglycerin. Which of the following instructions should the nurse include in the discharge teaching?

• A. Store the medication in a cool, dark place.
• B. Take the medication at bedtime.
• C. Take the medication on an empty stomach.
• D. Take the medication at the first sign of chest pain.

Correct answer: D

Rationale: The correct instruction to include in the discharge teaching for a client with a new prescription for nitroglycerin is to take the medication at the first sign of chest pain. Nitroglycerin is a vasodilator that helps relax blood vessels, increasing blood flow to the heart muscle and reducing the workload of the heart. Taking it at the onset of chest pain helps alleviate angina symptoms quickly and effectively. Storing the medication in a cool, dark place (Choice A) is not a critical instruction for this medication. Taking the medication at bedtime (Choice B) or on an empty stomach (Choice C) is not relevant to the administration of nitroglycerin for angina relief.

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