Nursing Elites

1. The nurse is preparing a client for discharge after a myocardial infarction (MI). Which instruction is most important for the nurse to reinforce with the client?

• A. Avoid engaging in sexual activity for at least 6 weeks.
• B. Engage in moderate physical activity daily.
• C. Take prescribed medications even if you feel well.
• D. Return to work only when medically cleared.

Correct answer: C

Rationale: The most critical instruction for a client after a myocardial infarction is to continue taking prescribed medications even if they feel well. This is essential in preventing another myocardial infarction or other complications. Discontinuing medications prematurely can be detrimental to the client's recovery and may increase the risk of further cardiovascular events. Choices A, B, and D are incorrect because engaging in sexual activity, physical activity, or returning to work are important aspects of the client's recovery, but not as crucial as ensuring medication compliance to prevent further cardiac issues.

2. A client with atrial fibrillation is receiving warfarin (Coumadin). The nurse should reinforce which instruction?

• A. Avoid foods high in vitamin K.
• B. Increase intake of dairy products.
• C. Limit intake of high-fiber foods.
• D. Avoid protein-rich foods.

Correct answer: A

Rationale: The correct answer is A: Avoid foods high in vitamin K. Clients taking warfarin need to be cautious with their vitamin K intake because vitamin K can counteract the effects of the medication. Therefore, it is essential to avoid foods high in vitamin K to maintain the therapeutic effects of warfarin. Choice B is incorrect because increasing dairy product intake is not specifically related to warfarin therapy. Choice C is incorrect as high-fiber foods do not interfere with warfarin therapy. Choice D is incorrect as protein-rich foods are not contraindicated with warfarin therapy.

3. A client is taking levothyroxine for hypothyroidism. Which of the following findings should indicate to the healthcare provider that the client is experiencing levothyroxine toxicity?

• A. Weight loss
• B. Insomnia
• C. Heat intolerance
• D. Dry skin

Correct answer: C

Rationale: Heat intolerance is a hallmark sign of levothyroxine toxicity. It indicates that the client may be receiving an excessive dose of levothyroxine, leading to hyperthyroid symptoms. This can happen when the dosage is too high, causing the body to have an excess of thyroid hormone. Weight loss is a common symptom of hyperthyroidism but alone does not specifically indicate levothyroxine toxicity. Insomnia can be related to hyperthyroidism but is not a specific sign of levothyroxine toxicity. Dry skin is more commonly associated with hypothyroidism rather than levothyroxine toxicity.

4. A client with a history of angina is scheduled for an exercise electrocardiography (ECG) test. The nurse should explain that the purpose of this test is to evaluate which factor?

• A. The heart's response to physical stress
• B. The client's overall physical fitness
• C. The presence of electrolyte imbalances
• D. The effectiveness of anti-anginal medications

Correct answer: A

Rationale: An exercise electrocardiography (ECG) test is used to evaluate the heart's response to physical stress. During the test, the heart's electrical activity is monitored while the client exercises, helping to identify any areas of ischemia or abnormal rhythms. This test helps healthcare providers assess the heart's function and detect any potential issues related to angina or other cardiac conditions. Choice B, the client's overall physical fitness, is incorrect because the test primarily focuses on the heart's response to stress rather than the client's general physical fitness. Choice C, the presence of electrolyte imbalances, is incorrect as this test is not specifically designed to evaluate electrolyte levels. Choice D, the effectiveness of anti-anginal medications, is incorrect as the main purpose of the test is to assess the heart's response to physical stress, not medication effectiveness.

5. The nurse is caring for a client with hypertension who is prescribed enalapril (Vasotec). The nurse should monitor the client for which potential adverse effect?

• A. Hypertension
• B. Hypotension
• C. Tachycardia
• D. Hyperglycemia

Correct answer: B

Rationale: The correct answer is B: Hypotension. Enalapril is an ACE inhibitor that works by dilating blood vessels and reducing blood pressure. Therefore, a potential adverse effect of enalapril is hypotension, not hypertension (choice A), tachycardia (choice C), or hyperglycemia (choice D). Monitoring for hypotension is crucial to prevent complications.

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