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. The nurse is assisting in the care of a client with a history of chronic obstructive pulmonary disease (COPD) who is on oxygen therapy. Which action should the nurse take to ensure the client's safety?

• A. Set the oxygen flow rate to 4 liters per minute.
• B. Remove oxygen while the client is eating.
• C. Ensure the client wears a nasal cannula instead of a face mask.
• D. Maintain the oxygen flow rate at the lowest level that relieves hypoxia.

Correct answer: D

Rationale: For clients with COPD, too much oxygen can suppress their drive to breathe, leading to hypoventilation. Therefore, the nurse should maintain the oxygen flow rate at the lowest level that relieves hypoxia to prevent complications while ensuring adequate oxygenation. Setting the oxygen flow rate too high (Choice A) can be detrimental for the client with COPD. Removing oxygen while the client is eating (Choice B) can compromise oxygenation, which is essential even during meals. While nasal cannulas are commonly used, the choice of oxygen delivery device depends on the client's needs; there may be situations where a face mask (Choice C) is more appropriate.

3. The client has angina pectoris and is prescribed nitroglycerin patches. What instruction should the nurse provide to the client?

• A. Apply the patch to the chest and leave it in place for 24 hours
• B. Apply the patch to a different site each time to prevent skin irritation
• C. Remove the patch before going to bed to prevent tolerance
• D. Cut the patch in half if experiencing headaches

Correct answer: B

Rationale: The correct instruction for the nurse to provide to the client is to apply the nitroglycerin patch to a different site each time to prevent skin irritation. Rotating the application site is crucial to prevent skin irritation and ensure consistent absorption of the medication. Applying the patch to the same site can lead to skin irritation and decreased effectiveness. Removing the patch before going to bed is not necessary, as the patch can typically be worn for a specific duration. Cutting the patch in half if experiencing headaches is not recommended and can alter the dose of the medication.

4. A healthcare professional is assessing a client who is taking digoxin. Which of the following findings should the healthcare professional report to the provider?

• A. Weight gain
• B. Dry cough
• C. Hypokalemia
• D. Bradycardia

Correct answer: D

Rationale: Bradycardia is a significant finding in a client taking digoxin as it is a sign of digoxin toxicity. Bradycardia can indicate that the client is experiencing an adverse reaction to the medication, potentially leading to serious complications. Therefore, it is crucial for the healthcare professional to report bradycardia to the provider promptly for further evaluation and intervention. Weight gain, dry cough, and hypokalemia are not typically associated with digoxin toxicity and may have other underlying causes. While weight gain and cough can be monitored, bradycardia requires immediate attention due to its potential link to digoxin toxicity.

5. The healthcare provider is setting up the bedside unit for a client being admitted to the nursing unit from the emergency department with a diagnosis of coronary artery disease (CAD). The provider should place the highest priority on making sure that which is available at the bedside?

• A. Bedside commode
• B. Rolling shower chair
• C. Oxygen tubing and flowmeter
• D. Twelve-lead electrocardiogram (ECG) machine

Correct answer: C

Rationale: In a client with coronary artery disease (CAD), ensuring the availability of oxygen and a flowmeter at the bedside is crucial. Oxygen is essential for adequate oxygenation, which helps prevent myocardial ischemia, a common complication in CAD. The other options, such as a bedside commode and rolling shower chair, are important for patient comfort and mobility but are not as critical as ensuring proper oxygen supply in a client with CAD. While having an ECG machine available is important for ongoing monitoring, ensuring oxygen availability takes precedence in this scenario.

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