Nursing Elites

1. The client is scheduled to undergo a treadmill stress test. Which instruction should the client be reinforced with?

• A. Eat a light meal before the test.
• B. Wear comfortable shoes and clothing.
• C. Avoid all physical activity the morning of the test.
• D. Take prescribed medications right before the test.

Correct answer: B

Rationale: The correct answer is B: 'Wear comfortable shoes and clothing.' Wearing comfortable shoes and clothing is crucial for the client undergoing a treadmill stress test to ensure they can complete the test without discomfort. The right attire will help the client move freely and reduce the risk of any hindrance during the test, which requires physical activity. Choices A, C, and D are incorrect. A light meal before the test may be recommended, but it's not as crucial as wearing suitable attire. Avoiding physical activity the morning of the test is not necessary as the test requires physical activity. Taking prescribed medications right before the test instructions should be followed as per the healthcare provider's advice and not as a general rule for all clients undergoing the test.

2. The client is receiving intravenous heparin for the treatment of a pulmonary embolism. Which medication should the nurse ensure is readily available?

• A. Protamine sulfate
• B. Vitamin K
• C. Calcium gluconate
• D. Magnesium sulfate

Correct answer: A

Rationale: Protamine sulfate is the antidote for heparin, used to reverse its anticoagulant effects. It should be readily available in case of bleeding complications, as it can rapidly neutralize the effects of heparin and prevent excessive bleeding. Vitamin K is used to reverse the effects of warfarin, not heparin (Choice B). Calcium gluconate is used to treat calcium deficiencies, not indicated for heparin therapy (Choice C). Magnesium sulfate is used for conditions like preeclampsia and eclampsia, not for reversing heparin effects (Choice D).

3. The nurse is assisting with the care of a client diagnosed with heart failure. Which finding should the nurse report to the healthcare provider immediately?

• A. Weight gain of 2 pounds in 2 days
• B. Increased urination at night
• C. Mild shortness of breath on exertion
• D. Decreased appetite and fatigue

Correct answer: A

Rationale: A weight gain of 2 pounds in 2 days is concerning in a client with heart failure as it can indicate fluid retention and worsening of the condition. This finding requires immediate medical attention to prevent further complications. Increased urination at night (choice B) may be due to various reasons like diuretic use and is not an immediate concern. Mild shortness of breath on exertion (choice C) is expected in clients with heart failure and may not require immediate reporting. Decreased appetite and fatigue (choice D) are common symptoms in heart failure but are not as urgent as sudden weight gain.

4. The nurse is caring for a client with coronary artery disease (CAD) who reports chest pain. The nurse administers nitroglycerin as prescribed. What is the next priority action?

• A. Obtain a 12-lead ECG
• B. Monitor the client's blood pressure
• C. Notify the healthcare provider
• D. Administer a second dose of nitroglycerin

Correct answer: B

Rationale: After administering nitroglycerin, the next priority action is to monitor the client's blood pressure. Nitroglycerin can cause vasodilation and subsequent hypotension, so it is crucial to assess the client's blood pressure to prevent complications and ensure safety. Obtaining a 12-lead ECG may be necessary but monitoring blood pressure takes precedence to detect and manage potential hypotension. Notifying the healthcare provider can be done after ensuring the client's stability. Administering a second dose of nitroglycerin without assessing the client's response and blood pressure can lead to further hypotension.

5. A client with hypertension is prescribed metoprolol (Lopressor). The nurse should monitor the client for which side effect?

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

Correct answer: B

Rationale: Metoprolol is a beta-blocker that works by slowing the heart rate. Therefore, the nurse should monitor the client for bradycardia, which is a potential side effect of metoprolol. Bradycardia refers to a heart rate that is slower than normal, and it can be a concern when administering medications like metoprolol that affect heart rate. Choices A, C, and D are incorrect as tachycardia (fast heart rate), hypertension (high blood pressure), and hyperglycemia (high blood sugar) are not typically associated with metoprolol use. In fact, metoprolol is used to treat hypertension and certain heart conditions by lowering heart rate and blood pressure.

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