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 healthcare provider provides teaching to a group of evacuees in a mass casualty center after a natural flooding disaster. Which information should the healthcare provider include in the teaching plan? (select one that does not apply.)

• A. wash all fruits and vegetables thoroughly in running tap water
• B. identify all sexual contacts since the evacuation process
• C. take all doses of prophylactic prescriptions for diarrhea
• D. clean hands using soap, clean water, or waterless antibacterial solutions

Correct answer: B

Rationale: In the aftermath of a flooding disaster, educating evacuees on proper hygiene practices like washing fruits and vegetables, taking prophylactic prescriptions, and practicing hand hygiene is crucial to prevent the spread of diseases. Option B, identifying sexual contacts, is not relevant to preventing post-disaster health risks and should not be included in the teaching plan.

3. An elderly client with limited mobility reports feeling isolated and lonely. Which intervention should the nurse prioritize?

• A. Arrange for regular visits from a home health aide
• B. Suggest the client join a local senior center
• C. Refer the client to a support group for seniors
• D. Recommend that the client engage in a new hobby

Correct answer: B

Rationale: The correct answer is to suggest the client join a local senior center. Joining a local senior center provides the elderly client with opportunities for social interaction, engagement in activities, and access to support systems, which can significantly help alleviate feelings of isolation and loneliness. Regular visits from a home health aide (Choice A) may provide physical assistance but may not address the client's need for social connection. Referring the client to a support group for seniors (Choice C) is beneficial, but joining a senior center offers a wider range of activities and social opportunities. Recommending a new hobby (Choice D) may be helpful, but the priority should be addressing the client's immediate need for social interaction and support.

4. A client with a history of hypertension is admitted with a blood pressure of 180/110 mm Hg. Which medication should the nurse prepare to administer?

• A. Atenolol (Tenormin)
• B. Nifedipine (Procardia)
• C. Hydrochlorothiazide (Microzide)
• D. Clonidine (Catapres)

Correct answer: D

Rationale: In this scenario of severe hypertension (180/110 mm Hg), the nurse should prepare to administer Clonidine (Catapres), which is an antihypertensive medication commonly used to rapidly lower blood pressure in acute situations. Atenolol and Nifedipine are also antihypertensive medications, but Clonidine is more appropriate for immediate blood pressure reduction in this critical situation. Hydrochlorothiazide is a diuretic often used for long-term management of hypertension, not for rapid lowering of severely elevated blood pressure.

5. The healthcare provider is assessing a client who has a new arteriovenous fistula in the left arm for hemodialysis. Which finding requires immediate intervention?

• A. A thrill is palpable on the fistula.
• B. The client's arm is warm and red.
• C. The fistula has a bruit on auscultation.
• D. There is no bruit on auscultation.

Correct answer: B

Rationale: The correct answer is B. Warmth and redness in the client's arm suggest infection or thrombosis of the arteriovenous fistula, which requires immediate intervention to prevent complications. A thrill (A) is a normal finding in a functional arteriovenous fistula, indicating good blood flow. A bruit (C) is also a normal finding on auscultation of a functioning arteriovenous fistula, indicating proper blood flow. The absence of a bruit (D) may indicate a non-functioning fistula, which would need further evaluation but does not require immediate intervention as warmth and redness do.

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