Nursing Elites

1. The nurse is caring for a client receiving anticoagulant therapy. Which instruction should the nurse reinforce with the client to prevent bleeding complications?

• A. Use a soft-bristle toothbrush and electric razor.
• B. Increase your intake of vitamin K-rich foods.
• C. Take aspirin if you have a headache.
• D. Avoid using ice packs for injuries.

Correct answer: A

Rationale: The correct instruction to prevent bleeding complications in a client on anticoagulant therapy is to use a soft-bristle toothbrush and an electric razor. These implements help reduce the risk of bleeding by being gentle on the skin and reducing the chances of cuts or abrasions that could lead to bleeding in individuals on anticoagulants. Choice B is incorrect because increasing intake of vitamin K-rich foods can interfere with the action of anticoagulants. Choice C is incorrect as aspirin is a blood thinner and can increase the risk of bleeding when combined with anticoagulant therapy. Choice D is incorrect as ice packs can help reduce bleeding and swelling in injuries, but in a client on anticoagulant therapy, it is important to avoid potential trauma to the skin that could lead to bleeding.

2. A client has a new prescription for enalapril. Which of the following adverse effects should the client be instructed to monitor and report?

• A. Frequent urination
• B. Tremors
• C. Dry mouth
• D. Persistent cough

Correct answer: D

Rationale: The correct answer is D: Persistent cough. Enalapril, an ACE inhibitor, is known to commonly cause a persistent cough as an adverse effect due to its effect on bradykinin levels. Clients should be instructed to monitor for a persistent cough and report it promptly to their healthcare provider for further evaluation and possible medication adjustment. Choices A, B, and C are incorrect as they are not commonly associated with enalapril use and are not typical adverse effects of ACE inhibitors.

3. When teaching a client who has a new prescription for metformin, which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Monitor for signs of hyperglycemia.
• C. Increase your fluid intake.
• D. Expect a metallic taste in your mouth.

Correct answer: C

Rationale: The correct instruction for a client starting metformin is to increase fluid intake. This is crucial to prevent gastrointestinal discomfort, a common side effect of metformin. Adequate hydration helps reduce the risk of gastrointestinal upset and ensures the medication is well-tolerated. Option A is generally true for metformin but is not as essential as maintaining proper hydration. Option B is important but not directly related to starting metformin. Option D is incorrect as a metallic taste in the mouth is not typically associated with metformin.

4. A client with peripheral artery disease (PAD) complains of pain in the legs while walking. Which instruction should the LPN/LVN reinforce to help alleviate the client's symptoms?

• A. Walk until the pain becomes severe, then rest.
• B. Perform leg exercises while sitting.
• C. Elevate the legs on pillows while resting.
• D. Take frequent breaks and walk shorter distances.

Correct answer: D

Rationale: The correct answer is to take frequent breaks and walk shorter distances. This instruction helps alleviate symptoms in clients with peripheral artery disease (PAD) by allowing them to manage pain and discomfort more effectively. Option A is incorrect as waiting for the pain to become severe before resting can exacerbate symptoms. Option B, performing leg exercises while sitting, may not directly address the issue of pain during walking. Option C, elevating the legs on pillows while resting, is beneficial for other conditions like edema but may not specifically help alleviate pain while walking in PAD clients.

5. The client's B-type natriuretic peptide (BNP) level is 691 pg/mL. Which intervention should the nurse implement when providing care for the client?

• A. Take daily weights and monitor trends.
• B. Encourage fluid intake to improve hydration.
• C. Elevate the legs above the level of the heart.
• D. Position the client supine with the head of the bed at 30 degrees.

Correct answer: A

Rationale: Elevated BNP levels are indicative of heart failure, which often causes fluid retention and weight gain. Taking daily weights and monitoring trends allows the nurse to assess for changes in fluid status. This intervention helps in evaluating the effectiveness of the treatment plan and identifying worsening heart failure symptoms early. Encouraging fluid intake (Choice B) might exacerbate fluid overload in a client with elevated BNP levels. Elevating the legs (Choice C) and positioning the client supine with the head of the bed at 30 degrees (Choice D) are interventions more suitable for clients with hypotension, not specifically indicated for managing elevated BNP levels.

Similar Questions