Nursing Elites

1. A client asks the nurse to explain the difference between stable and unstable angina. What is the best response by the nurse?

• A. "Stable angina is predictable in its frequency, intensity, and duration. Unstable angina is when angina episodes become more frequent or severe, and occur during periods of rest."?
• B. "Unstable angina is caused by spasms of the coronary arteries. Stable angina is when angina episodes become more frequent or severe, and occur during periods of rest."?
• C. "Unstable angina is predictable in its frequency, intensity, and duration. Stable angina is when angina episodes become more frequent or severe, and occur during periods of rest."?
• D. "Stable angina is caused by spasms of the coronary arteries. Unstable angina is when angina episodes become more frequent or severe, and occur during periods of rest."?

Correct answer: A

Rationale: Stable angina is typically triggered by physical exertion or emotional stress and is predictable in its frequency, intensity, and duration. In contrast, unstable angina is characterized by angina episodes that are unexpected, more severe, prolonged, and can occur at rest. Understanding these differences can help healthcare providers assess and manage angina episodes effectively, ensuring appropriate interventions are implemented promptly based on the type of angina present.

2. A client has a new prescription for Hydrochlorothiazide. Which of the following instructions should the nurse include?

• A. Take the medication in the morning.
• B. Increase your intake of potassium-rich foods.
• C. Expect decreased urination within the first few days.
• D. Avoid foods high in potassium.

Correct answer: B

Rationale: The correct answer is B: 'Increase your intake of potassium-rich foods.' Hydrochlorothiazide is a diuretic that can lead to hypokalemia by increasing potassium excretion. Therefore, instructing the client to increase their intake of potassium-rich foods is essential to prevent electrolyte imbalances and support overall health. Choices A, C, and D are incorrect. Instructing the client to take the medication in the morning is not directly related to the medication's mechanism of action. Expecting decreased urination within the first few days is not accurate as the medication is a diuretic that typically increases urination. Also, advising the client to avoid foods high in potassium would not be suitable, as increasing potassium-rich foods is necessary to counteract potential potassium depletion caused by Hydrochlorothiazide.

3. A client has a new prescription for Clonidine to assist with maintenance of abstinence from opioids. The nurse should instruct the client to monitor for which of the following adverse effects?

• A. Diarrhea
• B. Dry mouth
• C. Insomnia
• D. Hypertension

Correct answer: B

Rationale: Dry mouth is a common adverse effect associated with clonidine use. Clonidine is known to cause xerostomia (dry mouth) due to its effect on reducing salivary flow. Monitoring for dry mouth is important as it can lead to oral health issues and discomfort for the client. Diarrhea, insomnia, and hypertension are not typically associated with clonidine use, making them less likely adverse effects to monitor for in this scenario.

4. A client is taking Epoetin Alfa for anemia. Which of the following laboratory tests should the nurse monitor to evaluate the effectiveness of the therapy?

• A. White blood cell count
• B. Platelet count
• C. Hematocrit
• D. Serum potassium level

Correct answer: C

Rationale: The nurse should monitor the hematocrit level to evaluate the effectiveness of Epoetin Alfa therapy. Epoetin Alfa stimulates red blood cell production, leading to an increase in hematocrit levels. Monitoring the hematocrit helps assess the response to therapy and ensures that the medication is effectively addressing the anemia. White blood cell count and platelet count are not directly affected by Epoetin Alfa therapy. Serum potassium level monitoring is important for other medications that may impact potassium levels but is not specifically relevant to assessing the effectiveness of Epoetin Alfa in treating anemia.

5. A healthcare professional reviewing a client's health record notes a new prescription for Lisinopril 10 mg PO once daily. The healthcare professional should identify this as which of the following types of prescription?

• A. Single
• B. Stat
• C. Routine
• D. Standing

Correct answer: C

Rationale: A routine prescription indicates that the medication is to be administered on a regular schedule, typically daily, without a specified termination date or a specific number of doses. In this case, Lisinopril 10 mg PO once daily is to be given regularly until the healthcare provider decides to discontinue it. This type of prescription is common for medications that are part of the client's ongoing treatment regimen. The other choices are incorrect: 'Single' does not provide information about the frequency or duration of administration, 'Stat' indicates an urgent, one-time administration, and 'Standing' refers to a prescription that is automatically renewed without the need for a new order for each administration.

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