Nursing Elites

1. The client is reinforcing teaching for peripheral artery disease (PAD). Which statement by the client indicates correct understanding?

• A. I will keep my legs elevated on pillows while resting.
• B. I will avoid crossing my legs when sitting.
• C. I will wear tight compression stockings to improve circulation.
• D. I will apply heat to my legs to relieve pain and improve circulation.

Correct answer: B

Rationale: The correct answer is B. Crossing the legs can further impede blood flow in clients with PAD, worsening symptoms. Avoiding leg crossing helps maintain adequate blood flow and reduces the risk of complications associated with peripheral artery disease. Choices A, C, and D are incorrect because elevating the legs, wearing tight compression stockings, and applying heat can exacerbate symptoms in PAD by restricting blood flow or causing potential harm.

2. A client has a new prescription for amitriptyline. Which of the following instructions should the nurse include?

• A. Take the medication in the morning.
• B. Avoid consuming grapefruit juice.
• C. Take the medication with a full glass of water.
• D. Monitor for signs of weight gain.

Correct answer: C

Rationale: When a client is prescribed amitriptyline, it is important to instruct them to take the medication with a full glass of water. This instruction helps prevent esophageal irritation, as amitriptyline can be harsh on the esophagus. Option C is the correct choice. Option A, taking the medication in the morning, is not specific to amitriptyline and can vary depending on the individual's condition. Option B, avoiding grapefruit juice, is a general precaution for many medications but not specifically related to amitriptyline. Option D, monitoring for signs of weight gain, is not a direct instruction for taking the medication itself and may not be a common side effect of amitriptyline.

3. The healthcare provider is preparing to administer a calcium channel blocker to a client with hypertension. What parameter should be checked before administering the medication?

• A. Apical pulse
• B. Serum calcium level
• C. Blood pressure
• D. Respiratory rate

Correct answer: C

Rationale: Before administering a calcium channel blocker to a client with hypertension, the healthcare provider should check the client's blood pressure. Calcium channel blockers are used to lower blood pressure, making it essential to assess the current blood pressure to ensure it is within the appropriate range for administration. Checking the apical pulse (choice A) is not the priority before administering a calcium channel blocker, as the focus should be on blood pressure. Serum calcium level (choice B) is not directly related to the administration of calcium channel blockers for hypertension. Respiratory rate (choice D) is not the primary parameter to check before administering a calcium channel blocker in this scenario.

4. Why should the client diagnosed with rheumatic heart disease be advised to notify the dentist before dental procedures?

• A. The client requires prophylactic antibiotics before treatment.
• B. The client may experience dysrhythmias with high-speed drills.
• C. The client may have an adverse reaction to lidocaine with epinephrine.
• D. The client may develop heart failure during stressful events.

Correct answer: A

Rationale: Clients with rheumatic heart disease are at risk for infective endocarditis, a serious infection of the heart lining or valves. They need prophylactic antibiotics before invasive procedures, including dental work, to prevent this life-threatening complication. While dysrhythmias with high-speed drills, adverse reactions to local anesthesia, and the risk of heart failure during stressful events are all concerns for clients with heart conditions, the primary reason for notifying the dentist before dental procedures in rheumatic heart disease is the need for prophylactic antibiotics to prevent infective endocarditis.

5. A client is receiving morphine for pain. Which of the following assessments is the priority?

• A. Urine output
• B. Pupil reaction
• C. Respiratory rate
• D. Bowel sounds

Correct answer: C

Rationale: The correct answer is C: Respiratory rate. Monitoring the respiratory rate is the priority assessment for a client receiving morphine due to the risk of respiratory depression. Morphine is a potent opioid that can cause respiratory depression, which is a serious adverse effect that can be life-threatening. Assessing the client's respiratory rate is crucial to detect any signs of respiratory depression early and intervene promptly. Assessing urine output is important but not as critical as monitoring for respiratory depression with morphine. Pupil reaction and bowel sounds are also important assessments but do not take precedence over monitoring the respiratory rate when a client is on morphine.

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