Nursing Elites

1. A client has just completed an information session about measures to minimize the progression of coronary artery disease (CAD). Which statement indicates an initial understanding of lifestyle alterations?

• A. I should take daily medication for life.
• B. I should eat a diet that is low in fat and cholesterol.
• C. I should continue to smoke to keep the metabolic rate high.
• D. I should begin to exercise if the diet is not sufficient to achieve weight loss.

Correct answer: B

Rationale: Choosing a diet that is low in fat and cholesterol is crucial for managing and preventing the progression of coronary artery disease (CAD). This dietary change can help reduce the risk of further complications associated with CAD, such as plaque buildup in the arteries. It is a fundamental lifestyle alteration that can positively impact the client's heart health. Option A is incorrect as relying solely on medication without lifestyle changes may not address the root cause of CAD. Option C is incorrect as smoking is harmful and worsens CAD. Option D is incorrect because exercise is a crucial part of a healthy lifestyle, but dietary changes should come first in managing CAD.

2. The healthcare provider is teaching a client about the use of nitroglycerin patches for angina pectoris. Which instruction should the healthcare provider include?

• A. Apply the patch to the same site each day
• B. Remove the patch at bedtime to prevent tolerance
• C. Cover the patch with a bandage to keep it in place
• D. Rotate the application site every 24 hours

Correct answer: D

Rationale: Rotating the application site every 24 hours is crucial when using nitroglycerin patches to prevent skin irritation and ensure consistent absorption of the medication. By rotating the site, the risk of local skin reactions is reduced, and the effectiveness of the nitroglycerin patch is maintained. Applying the patch to the same site each day (Choice A) can lead to skin irritation. Removing the patch at bedtime (Choice B) is not necessary as long as the prescribed wearing schedule is followed. Covering the patch with a bandage (Choice C) is not recommended as it may interfere with proper absorption.

3. The nurse is caring for a client with a diagnosis of myocardial infarction (MI) and is assisting the client in completing the diet menu. Which beverage does the nurse instruct the client to select from the menu?

• A. Tea
• B. Cola
• C. Coffee
• D. Lemonade

Correct answer: D

Rationale: Lemonade is the correct choice as it is caffeine-free, unlike tea, cola, and coffee, which contain caffeine that can potentially affect the client's heart rhythm. Caffeine can increase heart rate and blood pressure, which may not be advisable for a client with a recent MI. Tea, cola, and coffee should be avoided due to their caffeine content, which can have stimulant effects on the heart and may not be beneficial for a client recovering from a myocardial infarction.

4. The nurse is assisting in the care of a client with a history of angina pectoris who is receiving nitroglycerin patches. Which instruction should the nurse reinforce with the client?

• A. Apply the patch to a different site each time.
• B. Remove the patch at night to prevent tolerance.
• C. Use more than one patch if chest pain occurs.
• D. Shower with caution while wearing the patch.

Correct answer: B

Rationale: Removing the nitroglycerin patch at night is crucial to prevent the development of tolerance. Tolerance can occur when the body becomes accustomed to a constant level of the medication, reducing its effectiveness. By removing the patch at night, the client experiences a drug-free period, which helps prevent tolerance and maintains the effectiveness of the nitroglycerin for angina relief. Choices A, C, and D are incorrect because applying the patch to a different site each time helps prevent skin irritation, using more than one patch is not recommended unless instructed by the healthcare provider, and showering with caution is important to prevent dislodging the patch, but it is not the most critical instruction to prevent tolerance development.

5. A client has a new prescription for transdermal nitroglycerin patches. Which of the following instructions should be included for proper use?

• A. Apply the patch to the same site each day.
• B. Place the patch on an area of skin away from skin folds and joints.
• C. Keep the patch on 24 hours per day.
• D. Replace the patch every 72 hours.

Correct answer: B

Rationale: Placing the nitroglycerin patch on an area of skin away from skin folds and joints is crucial to ensure optimal absorption and effectiveness of the medication. Placing the patch on skin folds or joints can interfere with absorption, potentially reducing the patch's efficacy. Therefore, it is essential to follow this instruction to maximize the therapeutic benefits of the nitroglycerin patches. The other options are incorrect because applying the patch to the same site each day can lead to skin irritation, keeping the patch on 24 hours per day may not be necessary depending on the specific patch instructions, and replacing the patch every 72 hours is not the standard frequency for nitroglycerin patches.

Similar Questions