Nursing Elites

1. After a client with a history of myocardial infarction (MI) is prescribed aspirin, which instruction should the nurse include in the discharge teaching?

• A. Take the aspirin with food to prevent gastrointestinal upset
• B. Discontinue the aspirin if you experience ringing in your ears
• C. Take the aspirin at bedtime to minimize side effects
• D. Avoid taking aspirin if you are also taking other NSAIDs

Correct answer: A

Rationale: The correct instruction is to take aspirin with food to prevent gastrointestinal upset. Aspirin can irritate the stomach lining, leading to potential gastrointestinal issues. Taking it with food helps reduce this risk by providing a protective layer in the stomach. This is a common recommendation to minimize the risk of gastrointestinal side effects when taking aspirin. Choices B, C, and D are incorrect. Choice B is not a typical reason to discontinue aspirin, as ringing in the ears is not a common side effect of aspirin. Choice C does not have a direct correlation to minimizing side effects of aspirin. Choice D is inaccurate because while caution should be exercised when taking aspirin with other NSAIDs due to the increased risk of bleeding, it does not mean aspirin should be entirely avoided if other NSAIDs are being taken.

2. The healthcare provider is preparing to assist in the care of a client who has just returned from coronary artery bypass graft (CABG) surgery. Which is the priority action?

• A. Monitor the client's urine output.
• B. Check the client's surgical dressing.
• C. Measure the client's blood pressure.
• D. Assess the client's level of consciousness.

Correct answer: D

Rationale: Assessing the client's level of consciousness is the priority action post-CABG surgery to monitor for signs of cerebral hypoxia or other complications that require immediate intervention. Changes in the client's level of consciousness can indicate neurological deterioration, which is critical to address promptly in this postoperative period. Monitoring urine output, checking surgical dressing, and measuring blood pressure are important aspects of postoperative care but assessing the client's level of consciousness takes precedence as it provides crucial information about the client's neurological status and the need for urgent intervention.

3. The client is scheduled to undergo a treadmill stress test. Which instruction should the client be reinforced with?

• A. Eat a light meal before the test.
• B. Wear comfortable shoes and clothing.
• C. Avoid all physical activity the morning of the test.
• D. Take prescribed medications right before the test.

Correct answer: B

Rationale: The correct answer is B: 'Wear comfortable shoes and clothing.' Wearing comfortable shoes and clothing is crucial for the client undergoing a treadmill stress test to ensure they can complete the test without discomfort. The right attire will help the client move freely and reduce the risk of any hindrance during the test, which requires physical activity. Choices A, C, and D are incorrect. A light meal before the test may be recommended, but it's not as crucial as wearing suitable attire. Avoiding physical activity the morning of the test is not necessary as the test requires physical activity. Taking prescribed medications right before the test instructions should be followed as per the healthcare provider's advice and not as a general rule for all clients undergoing the test.

4. A client has a new prescription for allopurinol. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Increase your fluid intake.
• C. Avoid consuming dairy products.
• D. Take the medication in the morning.

Correct answer: B

Rationale: Increasing fluid intake is essential when taking allopurinol to prevent the formation of kidney stones. Allopurinol can increase the levels of uric acid in the body, which can lead to kidney stone formation. By increasing fluid intake, the client can help flush out excess uric acid and prevent the development of kidney stones. It is important to drink plenty of water throughout the day to maintain adequate hydration and reduce the risk of kidney stone formation. Choices A, C, and D are incorrect. Taking allopurinol with food or in the morning does not specifically relate to preventing kidney stone formation. Avoiding dairy products is not a standard recommendation when taking allopurinol.

5. When teaching a client about the use of lisinopril, which of the following instructions should the nurse include?

• A. Monitor your blood pressure regularly.
• B. Take the medication with food.
• C. Increase your intake of potassium-rich foods.
• D. Avoid grapefruit juice.

Correct answer: A

Rationale: The correct answer is to instruct the client to monitor their blood pressure regularly when taking lisinopril. Lisinopril is known to cause hypotension, so monitoring blood pressure is crucial to ensure it stays within a safe range. This monitoring helps in early detection of any potential issues related to low blood pressure, allowing for timely intervention. Choices B, C, and D are incorrect because taking lisinopril with food, increasing potassium-rich foods intake, and avoiding grapefruit juice are not specific instructions related to the safe and effective use of lisinopril.

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