Nursing Elites

1. A client has been prescribed amlodipine for hypertension. Which of the following adverse effects should the nurse instruct the client to report?

• A. Dry cough
• B. Dizziness
• C. Rash
• D. Headache

Correct answer: B

Rationale: The correct answer is B: 'Dizziness.' Amlodipine, a calcium channel blocker used for hypertension, can cause dizziness due to its blood pressure-lowering effects. It is crucial for clients to report dizziness to their healthcare provider as it may indicate hypotension. Dry cough (choice A) is more commonly associated with ACE inhibitors, rash (choice C) may be seen in allergic reactions, and headache (choice D) is a less common side effect of amlodipine.

2. A nurse is caring for a client who is 8 hours postpartum following a vaginal birth. The client reports passing large clots and heavy bleeding. Which of the following actions should the nurse take?

• A. Massage the fundus
• B. Administer methylergonovine
• C. Increase the IV fluid rate
• D. Notify the healthcare provider

Correct answer: A

Rationale: Heavy bleeding and the passage of large clots after childbirth can indicate uterine atony. The nurse should first attempt to massage the fundus to stimulate uterine contractions and control the bleeding. Massaging the fundus helps the uterus to contract and may help prevent further bleeding. Administering methylergonovine (Choice B) is not the initial intervention for uterine atony. Increasing the IV fluid rate (Choice C) may not address the underlying cause of the bleeding. Notifying the healthcare provider (Choice D) can be done after attempting initial interventions like fundal massage.

3. A nurse is caring for a client with chronic pain. Which of the following interventions should the nurse prioritize?

• A. Administer pain medications as prescribed
• B. Encourage physical activity
• C. Monitor for depression
• D. Educate about alternative therapies

Correct answer: A

Rationale: Administering pain medications as prescribed is a priority to manage chronic pain effectively. Pain medications help alleviate the client's discomfort and improve their quality of life. Encouraging physical activity, monitoring for depression, and educating about alternative therapies are important interventions but may not directly address the immediate need for pain relief in a client with chronic pain. Physical activity and alternative therapies can be beneficial as part of a holistic pain management plan, but addressing the pain directly should be the initial priority.

4. A client at 38 weeks gestation with a history of herpes simplex virus 2 is being admitted. Which of the following questions is most appropriate to ask the client?

• A. Have your membranes ruptured?
• B. Do you have any active lesions?
• C. Are you positive for beta strep?
• D. How far apart are your contractions?

Correct answer: B

Rationale: The most appropriate question to ask a client with a history of herpes simplex virus 2 at 38 weeks gestation is whether they have any active lesions. Active herpes lesions during labor can necessitate a cesarean delivery to prevent neonatal transmission. Asking about ruptured membranes (choice A), beta strep status (choice C), or contraction timing (choice D) is important but not the priority when managing a client with a history of herpes simplex virus 2 due to the high risk of neonatal transmission.

5. A nurse is providing discharge instructions to a client after a myocardial infarction. Which of the following should be included?

• A. Resume normal activities immediately
• B. Monitor for chest pain and report any recurrence
• C. Avoid all physical activity for 6 months
• D. Take medications only as needed

Correct answer: B

Rationale: The correct answer is B: 'Monitor for chest pain and report any recurrence.' After a myocardial infarction, it is crucial for clients to be vigilant about any signs of chest pain as it could indicate a recurrent event. Prompt reporting of chest pain can lead to timely intervention, preventing further complications. Choice A is incorrect because resuming normal activities immediately after a heart attack can be dangerous and is not recommended. Choice C is also incorrect as avoiding all physical activity for 6 months is excessive and can lead to deconditioning. Choice D is incorrect as medications prescribed after a myocardial infarction are usually meant to be taken regularly as prescribed, not just as needed.

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