Nursing Elites

1. The client makes which statement about lifestyle changes to reduce the development and progression of coronary artery disease that indicates the need for further teaching?

• A. “I will check my weight regularly for any gain or loss.”
• B. “I’ll make sure to take my high blood pressure medications.”
• C. “I am attending a smoking cessation class.”
• D. “As long as I exercise, stress at my job will not bother me.”

Correct answer: D

Rationale: The client stating, 'As long as I exercise, stress at my job will not bother me,' indicates a misunderstanding of the relationship between exercise and stress management. It is important to clarify that while exercise can help reduce stress, it may not eliminate all stressors, especially those related to work. Further teaching is needed to ensure the client understands the multifactorial approach required to address stress and its impact on coronary artery disease.

2. A client with tobacco use disorder is being educated about Nicotine replacement therapy. Which statement by the client indicates an understanding of the teaching?

• A. I should avoid eating right before chewing a piece of nicotine gum.
• B. I will need to stop using the nicotine gum after 1 year.
• C. I know that nicotine gum is a safe alternative to smoking during pregnancy.
• D. I must chew the nicotine gum quickly for about 15 minutes.

Correct answer: A

Rationale: The correct answer is A. To maximize the effectiveness of nicotine gum, the client should avoid eating or drinking 15 minutes before and while using it. This helps ensure proper absorption of nicotine through the oral mucosa. Choice B is incorrect because the duration of nicotine gum use can vary depending on the individual's needs and progress. Choice C is incorrect as nicotine gum should be used during pregnancy only under healthcare provider guidance. Choice D is incorrect because nicotine gum should be chewed slowly until a tingling sensation is felt, then parked between the cheek and gum until the tingling stops.

3. Which drug classes are NOT typically used to treat angina?

• A. Calcium channel blockers
• B. Organic nitrates
• C. Alpha blockers
• D. Beta blockers

Correct answer: C

Rationale: Angina is primarily treated with calcium channel blockers, organic nitrates, and beta blockers. Alpha blockers are not commonly used in the treatment of angina. Calcium channel blockers help dilate blood vessels, decreasing the workload on the heart. Organic nitrates relax and widen blood vessels, improving blood flow and reducing the heart's workload. Beta blockers reduce the heart rate and blood pressure, decreasing the heart's demand for oxygen. Alpha blockers are more commonly used to treat conditions like hypertension and benign prostatic hyperplasia.

4. A healthcare provider is educating a client who has a prescription for Theophylline. Which of the following instructions should the healthcare provider include?

• A. Avoid caffeine while taking this medication.
• B. You should increase your fluid intake.
• C. Take this medication in the evening.
• D. You may experience increased appetite while on this medication.

Correct answer: A

Rationale: The correct answer is A: 'Avoid caffeine while taking this medication.' Caffeine can increase the risk of theophylline toxicity as it competes for the same metabolic pathways. Consuming caffeine while on theophylline can lead to adverse effects. Choice B is incorrect because although maintaining adequate hydration is important, it is not a specific instruction related to theophylline use. Choice C is incorrect as the timing of the medication administration should be based on the healthcare provider's recommendation and the client's individual needs. Choice D is incorrect as increased appetite is not a common side effect associated with theophylline.

5. A client is prescribed Spironolactone. Which of the following laboratory findings should the nurse monitor and report to the provider?

• A. Sodium level of 138 mEq/L
• B. Potassium level of 5.2 mEq/L
• C. Chloride level of 100 mEq/L
• D. Calcium level of 9.5 mg/dL

Correct answer: B

Rationale: Spironolactone is a potassium-sparing diuretic, causing potassium retention, potentially leading to elevated potassium levels. A potassium level of 5.2 mEq/L is above the normal range (3.5-5.0 mEq/L), indicating hyperkalemia, a serious condition. Elevated potassium levels can lead to life-threatening cardiac arrhythmias. Monitoring and reporting high potassium levels promptly to the healthcare provider are crucial to prevent potential complications. Sodium, chloride, and calcium levels are not directly influenced by Spironolactone, making choices A, C, and D incorrect.

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