Nursing Elites

1. A client is admitted with infective endocarditis (IE). Which symptom would alert the nurse to a complication of this condition?

• A. Dyspnea
• B. Heart murmur
• C. Macular rash
• D. Hemorrhage

Correct answer: B

Rationale: A new or changed heart murmur is a common sign of valve involvement in infective endocarditis, indicating a complication such as valve damage or regurgitation. Dyspnea is more commonly associated with respiratory or cardiac conditions not directly related to infective endocarditis. A macular rash is not a typical symptom of infective endocarditis, suggesting other conditions like infectious diseases. Hemorrhage is not a direct complication of infective endocarditis but may occur due to factors such as anticoagulant therapy or underlying bleeding disorders.

2. A client with a terminal illness is being cared for by a nurse. Which of the following findings indicates that the client's death is imminent?

• A. Cold extremities
• B. Increased appetite
• C. Elevated blood pressure
• D. Increased level of consciousness

Correct answer: A

Rationale: Cold extremities are a common sign observed in clients nearing death. This occurs due to decreased blood circulation as the body's systems begin to shut down. Cold extremities indicate poor perfusion and reduced function of vital organs. Increased appetite (Choice B) is not typically seen in clients approaching death; instead, a decreased appetite is more common. Elevated blood pressure (Choice C) is not a typical finding in clients nearing the end of life, as blood pressure tends to decrease. An increased level of consciousness (Choice D) is also not indicative of imminent death, as clients near death often experience decreased level of consciousness or become unresponsive.

3. A client with a history of heart failure is admitted with weight gain and peripheral edema. Which medication should the LPN/LVN anticipate being prescribed?

• A. Lisinopril (Zestril)
• B. Furosemide (Lasix)
• C. Metoprolol (Lopressor)
• D. Simvastatin (Zocor)

Correct answer: B

Rationale: Furosemide (Lasix) is the correct answer. In a client with heart failure experiencing weight gain and peripheral edema, the priority is to manage fluid overload. Furosemide is a loop diuretic commonly prescribed to reduce excess fluid in heart failure patients. Lisinopril (Zestril) is an ACE inhibitor used to treat hypertension and heart failure but does not directly address fluid overload. Metoprolol (Lopressor) is a beta-blocker that helps manage heart failure symptoms but does not primarily target fluid retention. Simvastatin (Zocor) is a statin used to lower cholesterol levels and is not indicated for managing fluid overload in heart failure.

4. A client who is postoperative is using an incentive spirometer. Into which of the following positions should the nurse place the client?

• A. Side-lying
• B. Supine
• C. Semi-Fowler’s
• D. Trendelenburg

Correct answer: C

Rationale: The correct position for a postoperative client using an incentive spirometer is the Semi-Fowler’s position. Placing the client in Semi-Fowler’s or high-Fowler’s position maximizes lung expansion and the effectiveness of the incentive spirometer. Side-lying may not provide optimal lung expansion. The supine position is not ideal for postoperative clients using incentive spirometers as it may limit lung expansion. The Trendelenburg position is not recommended due to potential complications postoperatively.

5. Which statement best describes time management strategies applied to the role of a nurse manager?

• A. Schedule staff efficiently to cover the needs of the managed unit
• B. Assume a fair share of direct client care to set an example
• C. Set daily goals with a prioritization of tasks
• D. Delegate tasks to reduce workload associated with direct care and meetings

Correct answer: C

Rationale: Setting daily goals and prioritizing tasks is crucial for effective time management as a nurse manager. This approach helps in organizing and focusing on the most important responsibilities, ensuring that key tasks are completed efficiently. Choice A is incorrect as scheduling staff efficiently, while important, is more related to staffing management than direct time management strategies. Choice B is incorrect as assuming direct client care does not necessarily align with effective time management strategies for a nurse manager, as their primary role is overseeing and coordinating care. Choice D, while delegation is a key aspect of time management, the emphasis on reducing workload specifically associated with direct care and meetings may not always be the primary focus of a nurse manager's time management strategies.

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