Nursing Elites

1. The client with diabetes mellitus has gangrene of the toes to the midfoot. Which goal should be included in this client's plan of care?

• A. Restore skin integrity.
• B. Prevent infection.
• C. Promote healing.
• D. Improve nutrition.

Correct answer: B

Rationale: Preventing infection is crucial in clients with gangrene to halt the spread of infection and avert further complications. Infections can exacerbate tissue damage and lead to systemic complications, making infection prevention a priority in the care plan for this client. Restoring skin integrity and promoting healing may not be achievable goals until the infection is under control. Improving nutrition is important for overall health but may not be the priority when the immediate concern is preventing infection.

2. The client with a history of coronary artery disease (CAD) is scheduled for a stress test. What instruction should the nurse provide to the client before the test?

• A. Continue taking your usual dose of beta-blockers
• B. Refrain from eating or drinking anything for 4 hours before the test
• C. Wear loose, comfortable clothing and walking shoes
• D. Avoid any physical activity for 24 hours before the test

Correct answer: C

Rationale: Before a stress test, the nurse should instruct the client to wear loose, comfortable clothing and walking shoes. This is essential as the stress test involves physical exercise, and the client should be ready for the activity involved. Continuing beta-blockers should be based on healthcare provider's instructions; adjustments may be needed. Fasting before the test is usually not necessary. Avoiding physical activity for 24 hours before the test is not recommended as it may affect the accuracy of the test results by not providing a true reflection of the client's exercise capacity.

3. A healthcare professional is assessing a client who has been taking levodopa/carbidopa for Parkinson's disease. Which of the following findings should the healthcare professional report to the provider?

• A. Dry mouth
• B. Urinary retention
• C. Bradykinesia
• D. Dizziness

Correct answer: C

Rationale: Bradykinesia is a cardinal symptom of Parkinson's disease characterized by slowness of movement. An increase in bradykinesia may indicate a decline in the client's condition and the need for adjustments in their medication regimen. Therefore, the healthcare professional should promptly report this finding to the provider for further evaluation and management. Choices A, B, and D are not directly related to the client's Parkinson's disease or the medication levodopa/carbidopa. Dry mouth is a common side effect of many medications, including anticholinergics, but not specifically levodopa/carbidopa. Urinary retention and dizziness are also not typically associated with levodopa/carbidopa use for Parkinson's disease.

4. A client reports chest pain that is unrelieved by three doses of nitroglycerin taken 5 minutes apart. What is the nurse's next best action?

• A. Administer another dose of nitroglycerin.
• B. Call the healthcare provider immediately.
• C. Provide oxygen via nasal cannula.
• D. Place the client in a supine position.

Correct answer: B

Rationale: In the scenario described, the client's chest pain persists despite three doses of nitroglycerin, indicating a potentially severe cardiac issue like a myocardial infarction. The priority for the nurse in this situation is to involve the healthcare provider promptly. Calling the healthcare provider immediately is essential to ensure timely evaluation and appropriate intervention for the client. Administering more nitroglycerin without further assessment or instructions may not be safe and could delay necessary treatments. Providing oxygen or changing the client's position may offer some comfort but does not address the underlying potentially life-threatening condition, making these options less appropriate as the immediate next best action.

5. A client has a new prescription for atenolol. Which of the following instructions should be included?

• A. Take the medication with food.
• B. Monitor heart rate daily.
• C. Avoid eating foods high in potassium.
• D. Take the medication at bedtime.

Correct answer: B

Rationale: The correct answer is to monitor heart rate daily. Atenolol is a beta-blocker that can lead to bradycardia, a condition characterized by a slow heart rate. Monitoring the heart rate daily is essential to detect any abnormal changes promptly, allowing for timely medical intervention if necessary. Choice A is incorrect because atenolol can be taken with or without food. Choice C is irrelevant as atenolol does not interact with potassium-rich foods. Choice D is incorrect as atenolol is usually taken in the morning to help manage blood pressure throughout the day.

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