Nursing Elites

1. The nurse is teaching a client about lifestyle changes to manage hypertension. Which dietary change should the nurse recommend?

• A. Increase intake of red meat
• B. Use salt substitutes liberally
• C. Limit sodium intake to 2 grams per day
• D. Increase intake of processed foods

Correct answer: C

Rationale: The correct answer is C: 'Limit sodium intake to 2 grams per day.' This recommendation is crucial in managing hypertension because excessive sodium intake can lead to elevated blood pressure. Reducing sodium intake helps the body regulate fluid balance and lower blood pressure. Choices A, B, and D are incorrect. Increasing red meat intake can worsen hypertension due to its high saturated fat content. Using salt substitutes liberally can also be harmful as they often contain high amounts of potassium, which can be problematic for individuals with certain health conditions. Increasing processed foods consumption is generally discouraged in hypertension management due to their high sodium content and low nutritional value.

2. Which statement indicates that a client with coronary artery disease (CAD) understands disease management?

• A. I will walk for one-half hour daily.
• B. As long as I exercise, I can eat anything I wish.
• C. My weight plays no role in this disease.
• D. My father's high cholesterol is irrelevant.

Correct answer: A

Rationale: Choice A is the correct answer because regular physical activity, such as walking for half an hour daily, is beneficial for managing coronary artery disease (CAD) and promoting heart health. Walking helps improve circulation, reduce cholesterol levels, and maintain a healthy weight, all of which are crucial for managing CAD. Choice B is incorrect because diet also plays a significant role in CAD management, not just exercise. Choice C is incorrect because weight management is essential in controlling CAD risk factors. Choice D is incorrect because family history of high cholesterol can increase the risk of CAD, making it relevant for disease management.

3. What preoperative instruction should the LPN/LVN reinforce to a client scheduled for a carotid endarterectomy?

• A. You will need to be NPO after midnight before the surgery.
• B. You should avoid deep breathing and coughing after the surgery.
• C. You will be able to eat and drink normally after the procedure.
• D. You can take all of your prescribed medications the morning of surgery.

Correct answer: A

Rationale: The correct preoperative instruction that the LPN/LVN should reinforce to a client scheduled for a carotid endarterectomy is being NPO after midnight before the surgery. This instruction is essential to prevent aspiration and ensure a safe procedure. Avoiding oral intake helps reduce the risk of complications during anesthesia induction and the surgical process. Choices B, C, and D are incorrect because avoiding deep breathing and coughing, resuming normal eating and drinking, and taking all prescribed medications the morning of surgery are not recommended preoperative instructions for a carotid endarterectomy.

4. A client with a history of angina pectoris reports chest pain while ambulating in the corridor. What should the nurse do first?

• A. Check the client's vital signs.
• B. Assist the client to sit or lie down.
• C. Administer sublingual nitroglycerin.
• D. Apply nasal oxygen at a rate of 2 L/min.

Correct answer: B

Rationale: When a client with a history of angina pectoris experiences chest pain while ambulating, the priority action for the nurse is to assist the client to sit or lie down. This helps reduce the demand on the heart by decreasing physical exertion. Checking vital signs, administering medication, or applying oxygen can follow once the client is in a more comfortable position. Checking vital signs (Choice A) may be important but addressing the immediate discomfort by positioning the client comfortably takes precedence. Administering sublingual nitroglycerin (Choice C) is appropriate but should come after ensuring the client's comfort. Applying nasal oxygen (Choice D) can be beneficial, but it should not be the first action; assisting the client to sit or lie down is the initial priority.

5. A nurse is providing teaching to a client who has a new prescription for warfarin. Which of the following statements should the nurse include?

• A. Avoid using a soft toothbrush.
• B. Report any signs of bleeding.
• C. Increase your intake of leafy green vegetables.
• D. Take the medication with food.

Correct answer: B

Rationale: The correct answer is B: 'Report any signs of bleeding.' When a patient is prescribed warfarin, it is essential to monitor for signs of bleeding as warfarin is an anticoagulant that increases the risk of bleeding. Choices A, C, and D are incorrect. Avoid using a soft toothbrush is not directly related to warfarin therapy, increasing the intake of leafy green vegetables can interfere with warfarin's effectiveness due to its vitamin K content, and taking warfarin with food is unnecessary as it can be taken with or without food.

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