Nursing Elites

1. A client with hypertension is prescribed metoprolol (Lopressor). The nurse should monitor the client for which side effect?

• A. Tachycardia
• B. Bradycardia
• C. Hypertension
• D. Hyperglycemia

Correct answer: B

Rationale: Metoprolol is a beta-blocker that works by slowing the heart rate. Therefore, the nurse should monitor the client for bradycardia, which is a potential side effect of metoprolol. Bradycardia refers to a heart rate that is slower than normal, and it can be a concern when administering medications like metoprolol that affect heart rate. Choices A, C, and D are incorrect as tachycardia (fast heart rate), hypertension (high blood pressure), and hyperglycemia (high blood sugar) are not typically associated with metoprolol use. In fact, metoprolol is used to treat hypertension and certain heart conditions by lowering heart rate and blood pressure.

2. A healthcare professional is assessing a client who has a new prescription for levothyroxine. Which of the following findings should the healthcare professional report to the provider?

• A. Weight gain
• B. Increased heart rate
• C. Heat intolerance
• D. Elevated blood pressure

Correct answer: C

Rationale: The correct answer is C: Heat intolerance. Heat intolerance is a concerning sign of levothyroxine toxicity and should be reported to the provider promptly. Levothyroxine is a medication used to treat hypothyroidism by supplementing the body's thyroid hormones. When a client experiences heat intolerance, it can indicate that the dose of levothyroxine is too high, leading to hyperthyroidism symptoms. Weight gain, increased heart rate, and elevated blood pressure are not typically associated with levothyroxine toxicity; instead, they are more commonly seen in conditions like hypothyroidism.

3. The healthcare provider is reinforcing instructions to a client with heart failure who is prescribed a low-sodium diet. The provider should advise the client to choose which food item?

• A. Canned soup
• B. Fresh vegetables
• C. Processed cheese
• D. Pickled vegetables

Correct answer: B

Rationale: Fresh vegetables are a suitable choice for clients on a low-sodium diet as they are naturally low in sodium and provide essential nutrients. In contrast, canned soup, processed cheese, and pickled vegetables tend to be high in sodium, which is not recommended for individuals with heart failure and on a low-sodium diet. Fresh vegetables are also rich in fiber, vitamins, and minerals, making them a healthier option compared to the other choices provided.

4. A client with a history of angina pectoris reports chest pain while ambulating in the corridor. What should the nurse do first?

• A. Check the client's vital signs.
• B. Assist the client to sit or lie down.
• C. Administer sublingual nitroglycerin.
• D. Apply nasal oxygen at a rate of 2 L/min.

Correct answer: B

Rationale: When a client with a history of angina pectoris experiences chest pain while ambulating, the priority action for the nurse is to assist the client to sit or lie down. This helps reduce the demand on the heart by decreasing physical exertion. Checking vital signs, administering medication, or applying oxygen can follow once the client is in a more comfortable position. Checking vital signs (Choice A) may be important but addressing the immediate discomfort by positioning the client comfortably takes precedence. Administering sublingual nitroglycerin (Choice C) is appropriate but should come after ensuring the client's comfort. Applying nasal oxygen (Choice D) can be beneficial, but it should not be the first action; assisting the client to sit or lie down is the initial priority.

5. A client has a history of left-sided heart failure. The nurse should look for the presence of which finding to determine whether the problem is currently active?

• A. Presence of ascites
• B. Bilateral lung crackles
• C. Jugular vein distention
• D. Pedal edema bilaterally

Correct answer: B

Rationale: When assessing a client with a history of left-sided heart failure, the presence of bilateral lung crackles is a key finding to determine if the condition is currently active. Crackles in the lungs indicate fluid accumulation, a common sign of left-sided heart failure due to pulmonary congestion. Choices A, C, and D are incorrect because ascites, jugular vein distention, and pedal edema are more commonly associated with right-sided heart failure.

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