Nursing Elites

1. The healthcare provider is teaching a client with hypertension about lifestyle modifications. Which recommendation should the healthcare provider include?

• A. Limit alcohol consumption to one drink per day.
• B. Increase sodium intake to maintain blood pressure.
• C. Exercise vigorously for at least 30 minutes daily.
• D. Avoid high potassium foods like bananas.

Correct answer: A

Rationale: Limiting alcohol intake is an essential lifestyle modification recommended for managing hypertension. Excessive alcohol consumption can raise blood pressure, so limiting it to one drink per day is beneficial in controlling hypertension. Alcohol moderation is a key part of a heart-healthy lifestyle for individuals with high blood pressure. Choice B is incorrect because increasing sodium intake can actually worsen hypertension by retaining water and increasing blood pressure. Choice C is incorrect because while exercise is important for overall health, moderate-intensity exercise is recommended for individuals with hypertension to avoid excessive strain on the heart. Choice D is incorrect because high potassium foods like bananas are actually beneficial for individuals with hypertension as they can help lower blood pressure.

2. When teaching a client who has a new prescription for metformin, which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Monitor for signs of hyperglycemia.
• C. Increase your fluid intake.
• D. Expect a metallic taste in your mouth.

Correct answer: C

Rationale: The correct instruction for a client starting metformin is to increase fluid intake. This is crucial to prevent gastrointestinal discomfort, a common side effect of metformin. Adequate hydration helps reduce the risk of gastrointestinal upset and ensures the medication is well-tolerated. Option A is generally true for metformin but is not as essential as maintaining proper hydration. Option B is important but not directly related to starting metformin. Option D is incorrect as a metallic taste in the mouth is not typically associated with metformin.

3. A client has a history of left-sided heart failure. The nurse should look for the presence of which finding to determine whether the problem is currently active?

• A. Presence of ascites
• B. Bilateral lung crackles
• C. Jugular vein distention
• D. Pedal edema bilaterally

Correct answer: B

Rationale: When assessing a client with a history of left-sided heart failure, the presence of bilateral lung crackles is a key finding to determine if the condition is currently active. Crackles in the lungs indicate fluid accumulation, a common sign of left-sided heart failure due to pulmonary congestion. Choices A, C, and D are incorrect because ascites, jugular vein distention, and pedal edema are more commonly associated with right-sided heart failure.

4. A client with a diagnosis of angina pectoris is prescribed nitroglycerin. The nurse should teach the client to take the medication in which way?

• A. Take one tablet daily with breakfast
• B. Take one tablet every 5 minutes as needed, up to three times
• C. Take one tablet every hour until pain subsides
• D. Take one tablet only if pain does not subside after 30 minutes

Correct answer: B

Rationale: Nitroglycerin is a rapid-acting medication used to relieve angina pain by dilating blood vessels. The correct administration is to take one tablet every 5 minutes as needed, up to three doses. This dosing regimen helps in managing acute angina episodes effectively. Choice A is incorrect because nitroglycerin is not taken once daily. Choice C is incorrect because waiting for an hour between doses may not provide timely relief during angina attacks. Choice D is incorrect as it suggests waiting for 30 minutes before taking another dose, which could delay symptom relief in acute situations.

5. The client with a history of angina pectoris reports chest pain unrelieved by nitroglycerin. Which action should the nurse take next?

• A. Administer another dose of nitroglycerin.
• B. Notify the healthcare provider immediately.
• C. Have the client lie down and rest.
• D. Encourage the client to take deep breaths.

Correct answer: B

Rationale: When a client with a history of angina pectoris reports chest pain unrelieved by nitroglycerin, it may indicate a myocardial infarction, also known as a heart attack. In this situation, the nurse should immediately notify the healthcare provider to ensure prompt evaluation and appropriate intervention. Delay in seeking medical attention for chest pain unrelieved by nitroglycerin can be life-threatening, as it might be a sign of a more serious cardiac event. Administering another dose of nitroglycerin (Choice A) without further evaluation can be risky, as the client's condition may require a different intervention. Having the client lie down and rest (Choice C) or encouraging deep breaths (Choice D) are not appropriate actions in this scenario where a more serious cardiac event needs to be ruled out.

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