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 healthcare professional is assessing a client who has been taking digoxin. Which of the following findings should the healthcare professional report to the provider?

• A. Weight gain
• B. Dry cough
• C. Hypokalemia
• D. Bradycardia

Correct answer: D

Rationale: The correct answer is D: Bradycardia. Bradycardia is a significant finding associated with digoxin toxicity. Digoxin, a medication commonly used to treat heart conditions, can lead to bradycardia as a sign of toxicity. Bradycardia requires immediate attention and reporting to the healthcare provider for further evaluation and management to prevent serious complications. Choices A, B, and C are incorrect because weight gain, dry cough, and hypokalemia are not specific signs of digoxin toxicity. While weight gain can be a side effect of digoxin, it is not a classic sign of toxicity. Dry cough is more commonly associated with medications like ACE inhibitors, and hypokalemia can be a complication of digoxin therapy but is not a direct sign of toxicity.

3. A client with a history of coronary artery disease is prescribed atorvastatin (Lipitor). What side effect should the nurse instruct the client to immediately report?

• A. Muscle pain or tenderness
• B. Constipation
• C. Dry mouth
• D. Drowsiness

Correct answer: A

Rationale: The correct answer is 'Muscle pain or tenderness.' This can be a sign of rhabdomyolysis, a serious side effect of statins like atorvastatin (Lipitor). Rhabdomyolysis is a condition in which muscle breakdown releases a protein that can damage the kidneys. Therefore, it is crucial for the client to report any muscle pain or tenderness immediately to prevent further complications. Choices B, C, and D are incorrect because they are not typically associated with atorvastatin (Lipitor) use or indicative of a serious adverse effect that requires immediate reporting.

4. The client admitted to the hospital with pulmonary edema is preparing for discharge. The client should be reminded of the importance of complying with which measure to prevent a recurrence?

• A. Weigh oneself every morning before breakfast.
• B. Sleep with the head elevated on multiple pillows.
• C. Adjust diuretic dose without healthcare provider guidance.
• D. Take additional digoxin (Lanoxin) as a preventive measure.

Correct answer: A

Rationale: Monitoring weight daily, especially in the morning before breakfast, is crucial in detecting fluid retention early and preventing pulmonary edema. Sudden weight gain can indicate fluid accumulation, prompting timely intervention to prevent complications. Choice A is the correct answer because daily weight monitoring is a key component in managing heart failure and preventing pulmonary edema recurrence. Choices B and D are not directly related to preventing fluid retention or pulmonary edema recurrence. Choice C is unsafe as adjusting diuretic doses without healthcare provider guidance can lead to electrolyte imbalances and worsening of the condition.

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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