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. A client diagnosed with angina pectoris returns to the nursing unit after experiencing an angioplasty. The nurse reinforces instructions to the client regarding the procedure and home care measures. Which statement by the client indicates an understanding of the instructions?

• A. I am considering cutting my workload.
• B. I need to cut down on cigarette smoking.
• C. I am so relieved that my heart is repaired.
• D. I need to adhere to my dietary restrictions.

Correct answer: B

Rationale: The correct answer is B because cutting down on cigarette smoking is crucial for improving heart health after angioplasty. Smoking cessation helps in reducing the risk of complications and promotes better outcomes. Choices A and C are not directly related to post-angioplasty care. While reducing workload may be beneficial, it is not specifically related to the client's cardiac health. Feeling relieved that the heart is repaired is a positive emotional response but does not reflect understanding of the necessary measures. Adhering to dietary restrictions is important, but in this scenario, smoking cessation takes higher priority due to its immediate impact on heart health.

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

• A. Use the inhaler every 4 hours around the clock.
• B. Shake the inhaler well before use.
• C. Rinse your mouth with water after each use.
• D. Use the inhaler while lying down.

Correct answer: B

Rationale: Shaking the inhaler well before use is crucial as it helps ensure proper mixing of the medication, which is essential for effective delivery of the drug to the lungs. This step is important for optimal therapeutic effects of albuterol inhalation. Choices A, C, and D are incorrect. Using the inhaler every 4 hours around the clock without specifying a maximum number of doses can lead to overuse. Rinsing the mouth with water after each use is typically advised for inhaled corticosteroids to reduce the risk of oral thrush, not for albuterol. Using the inhaler while lying down is not recommended as it may lead to improper medication delivery to the lungs.

4. A client with a diagnosis of heart failure is prescribed spironolactone (Aldactone). Which laboratory value should the nurse monitor closely?

• A. Serum calcium
• B. Serum potassium
• C. Serum sodium
• D. Serum glucose

Correct answer: B

Rationale: The correct answer is B: Serum potassium. Spironolactone is a potassium-sparing diuretic, which can lead to hyperkalemia. Monitoring serum potassium levels is crucial to prevent potential complications related to high potassium levels, such as cardiac arrhythmias. Therefore, close monitoring of serum potassium is essential for clients taking spironolactone. Choices A, C, and D are incorrect because spironolactone does not directly impact serum calcium, sodium, or glucose levels significantly. While these values may be monitored for other reasons in a client with heart failure, they are not the primary focus of monitoring when spironolactone is prescribed.

5. A client diagnosed with hypertension is prescribed atenolol (Tenormin). The nurse should monitor the client for which common side effect of this medication?

• A. Tachycardia
• B. Dry mouth
• C. Hypotension
• D. Increased appetite

Correct answer: C

Rationale: Atenolol is a beta-blocker that works by lowering blood pressure. A common side effect of atenolol is hypotension, where blood pressure drops too low. Therefore, the nurse should monitor the client for signs and symptoms of hypotension to prevent any complications. Choices A, B, and D are incorrect because tachycardia (fast heart rate), dry mouth, and increased appetite are not common side effects of atenolol. Hypotension is the expected side effect due to the medication's mechanism of action.

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