Nursing Elites

1. A client with a history of hypertension is prescribed enalapril (Vasotec). Which statement by the client indicates a need for further teaching?

• A. I will monitor my blood pressure regularly.
• B. I will report any signs of infection to my healthcare provider.
• C. I will avoid using salt substitutes.
• D. I will increase my intake of potassium-rich foods.

Correct answer: D

Rationale: The correct answer is D. Increasing potassium intake can lead to hyperkalemia, especially in clients taking ACE inhibitors like enalapril. Hyperkalemia is a potential side effect of ACE inhibitors and can be exacerbated by consuming potassium-rich foods. Monitoring blood pressure regularly (A) is important when taking antihypertensive medications. Reporting signs of infection (B) is crucial as ACE inhibitors can lower the immune response. Avoiding salt substitutes (C) is necessary because they may contain potassium chloride, leading to increased potassium levels, which can be harmful in combination with ACE inhibitors.

2. The nurse is preparing to administer an oral medication to a client with dysphagia. Which action should the nurse take?

• A. Crush the medication and mix it with applesauce.
• B. Have the client drink a full glass of water with the medication.
• C. Administer the medication with a small amount of pudding.
• D. Place the medication at the back of the client's tongue.

Correct answer: C

Rationale: The correct action for the nurse to take when administering oral medication to a client with dysphagia is to administer the medication with a small amount of pudding. This method helps prevent aspiration in clients with dysphagia by ensuring easier swallowing. Crushing the medication and mixing it with applesauce (Choice A) might alter the medication's efficacy. Having the client drink a full glass of water with the medication (Choice B) may not be suitable for a client with dysphagia as it can increase the risk of aspiration. Placing the medication at the back of the client's tongue (Choice D) can also lead to aspiration and is not recommended.

3. The healthcare professional is providing education on healthy eating habits to a group of adolescents. Which strategy is most likely to be effective?

• A. lecturing about the dangers of unhealthy eating
• B. distributing pamphlets on healthy food choices
• C. involving the adolescents in meal planning and preparation
• D. showing a documentary on the benefits of a healthy diet

Correct answer: C

Rationale: Involving adolescents in meal planning and preparation is a more effective strategy as it actively engages them in the learning process. This approach allows adolescents to have hands-on experience, make informed choices, and develop a sense of ownership over their dietary decisions. Lecturing about dangers or showing documentaries may not be as engaging or interactive, making it less likely for adolescents to retain and apply the information provided. Distributing pamphlets can be informative but lacks the interactive and experiential aspect that involving them in meal planning and preparation offers.

4. During which home visit performed by a registered nurse or a practical nurse can the home healthcare agency expect Medicare reimbursement for documenting a skilled care service provided?

• A. 13-18 years of age
• B. 11-12 years of age
• C. 18-24 months of age
• D. 4-6 years of age

Correct answer: D

Rationale: The correct answer is D: 4-6 years of age. According to current CDC guidelines, a child receiving the measles, mumps, rubella (MMR) vaccine at 12 months of age should plan to receive the MMR booster between 4-6 years of age. Choices A, B, and C are incorrect as they do not align with the CDC's recommended age range for the MMR vaccine booster. It is crucial for healthcare providers to stay updated with current guidelines to ensure the timely administration of vaccines for optimal protection.

5. A client with asthma receives a prescription for high blood pressure during a clinic visit. Which prescription should the nurse anticipate the client to receive that is least likely to exacerbate asthma?

• A. Pindolol (Visken)
• B. Carteolol (Ocupress)
• C. Metoprolol tartrate (Lopressor)
• D. Propranolol hydrochloride (Inderal)

Correct answer: C

Rationale: The correct answer is C, Metoprolol tartrate (Lopressor). Metoprolol is a beta2 blocking agent that is cardioselective and less likely to cause bronchoconstriction, making it a suitable antihypertensive option for clients with asthma. Choices A, B, and D are non-selective beta-blockers which can potentially exacerbate asthma symptoms by causing bronchoconstriction.

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