Nursing Elites

1. What is the best way to assess for fluid overload in a patient with heart failure?

• A. Check daily weight
• B. Check blood pressure
• C. Monitor heart sounds
• D. Assess for jugular vein distention

Correct answer: A

Rationale: The correct answer is to 'Check daily weight.' Monitoring daily weight is the most accurate method to assess for fluid overload in patients with heart failure. Weight gain can indicate fluid retention, a common issue in heart failure patients. Checking blood pressure (Choice B) can provide information about hemodynamic status but may not be as specific for fluid overload as monitoring weight. Monitoring heart sounds (Choice C) can provide information about cardiac function but may not directly assess fluid overload. Assessing for jugular vein distention (Choice D) can be a sign of increased central venous pressure but may not always correlate with fluid overload as accurately as daily weight checks.

2. What is the priority nursing intervention for a patient experiencing an acute asthma attack?

• A. Administer bronchodilators
• B. Administer corticosteroids
• C. Provide supplemental oxygen
• D. Start IV fluids

Correct answer: A

Rationale: The correct answer is to administer bronchodilators as the priority nursing intervention for a patient with an acute asthma attack. Bronchodilators help open the airways and improve airflow, which is crucial in managing acute asthma symptoms. Administering corticosteroids (Choice B) is also important in the treatment plan, but it is not the priority intervention during an acute attack. Providing supplemental oxygen (Choice C) may be necessary but is not the priority initial intervention. Starting IV fluids (Choice D) is not typically indicated as a priority intervention for an acute asthma attack.

3. A client with type 2 diabetes mellitus is scheduled for an arteriogram. Which of the following medications should the nurse instruct the client to discontinue 48 hours prior to the procedure?

• A. Atorvastatin
• B. Digoxin
• C. Nifedipine
• D. Metformin

Correct answer: D

Rationale: The correct answer is D, Metformin. Metformin should be discontinued 48 hours before an arteriogram due to the risk of lactic acidosis. Atorvastatin (Choice A) is a statin used to lower cholesterol levels and is not typically contraindicated before an arteriogram. Digoxin (Choice B) is a medication used for heart conditions and does not need to be discontinued before an arteriogram. Nifedipine (Choice C) is a calcium channel blocker used to treat high blood pressure and angina, and it is not necessary to discontinue before the procedure.

4. A client is receiving discharge teaching about a new prescription for ferrous sulfate. Which of the following statements by the client indicates an understanding of the teaching?

• A. I should take this medication with milk.
• B. I should expect my stools to turn black.
• C. I should avoid eating oranges while taking this medication.
• D. I will take this medication on an empty stomach.

Correct answer: B

Rationale: The correct answer is B. When taking ferrous sulfate, clients should expect their stools to turn black, which is a normal side effect due to the iron content. Choice A is incorrect because ferrous sulfate should not be taken with milk as it can decrease its absorption. Choice C is incorrect because vitamin C-rich foods like oranges can actually enhance the absorption of iron. Choice D is incorrect because ferrous sulfate is usually recommended to be taken on an empty stomach for better absorption.

5. A client is receiving discharge teaching for a new prescription of warfarin. Which statement by the client indicates an understanding of the teaching?

• A. I will need to increase my intake of leafy green vegetables.
• B. I will avoid drinking grapefruit juice while taking warfarin.
• C. I will have my INR checked regularly.
• D. I will take my medication at the same time each day.

Correct answer: C

Rationale: The correct answer is C. Clients on warfarin therapy need to have their International Normalized Ratio (INR) checked regularly to monitor the medication's effectiveness and prevent complications like clotting or bleeding. Option A is incorrect because increasing leafy green vegetables can affect INR levels due to their vitamin K content. Option B is incorrect as grapefruit juice is not a significant concern with warfarin. Option D is important for medication adherence but does not specifically address the monitoring aspect required for warfarin therapy.

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