Nursing Elites

1. A nurse is assessing a client who is taking amiodarone. Which of the following findings should the nurse report to the provider?

• A. Dry skin
• B. Weight loss
• C. Bradycardia
• D. Productive cough

Correct answer: D

Rationale: A productive cough can indicate pulmonary toxicity, a serious side effect of amiodarone, and should be reported. Dry skin is not typically associated with amiodarone use. Weight loss is a common side effect of amiodarone but not generally a cause for concern unless severe. Bradycardia is a known side effect of amiodarone and may not necessarily require immediate reporting unless symptomatic.

2. A client with a history of angina pectoris reports chest pain after climbing stairs. What should be the nurse's first action?

• A. Administer oxygen.
• B. Administer nitroglycerin.
• C. Sit the client down and rest.
• D. Check the client's blood pressure.

Correct answer: C

Rationale: The correct action for a client experiencing anginal pain, like chest pain after climbing stairs, is to sit the client down and have them rest. Resting reduces myocardial oxygen demand, which can help relieve anginal pain. Administering oxygen or nitroglycerin may be appropriate interventions after the client has been seated and rested. Checking the client's blood pressure is important but not the immediate priority when a client is experiencing anginal pain. Therefore, the first action should be to sit the client down and allow them to rest.

3. A client has a new prescription for digoxin. Which of the following instructions should the nurse include during discharge teaching?

• A. Take the medication with food.
• B. Monitor heart rate daily.
• C. Avoid consuming grapefruit juice.
• D. Increase intake of potassium-rich foods.

Correct answer: B

Rationale: The correct answer is B: 'Monitor heart rate daily.' When a client is prescribed digoxin, it is essential to monitor heart rate daily because digoxin can cause bradycardia, a condition characterized by a slow heart rate. Monitoring the heart rate regularly allows the client to promptly identify any signs of bradycardia and seek medical attention if needed. Choices A, C, and D are incorrect because taking digoxin with food, avoiding grapefruit juice, and increasing potassium-rich foods are not specific instructions related to managing the side effects or monitoring parameters of digoxin therapy.

4. The client with a history of left-sided heart failure is exhibiting increasing shortness of breath and frothy sputum. What is the priority nursing action?

• A. Administer oxygen
• B. Encourage coughing and deep breathing
• C. Place the client in a supine position
• D. Notify the healthcare provider immediately

Correct answer: A

Rationale: Shortness of breath and frothy sputum are indicative of pulmonary edema, a serious condition that requires immediate intervention to improve oxygenation. Administering oxygen is the priority action to support the client's respiratory function and prevent further deterioration. Oxygen therapy helps increase the oxygen levels in the blood, alleviate respiratory distress, and support vital organ function. Prompt intervention with oxygen can help stabilize the client while further assessments and treatments are initiated. Encouraging coughing and deep breathing may worsen the client's condition by increasing respiratory effort. Placing the client in a supine position can further compromise breathing in a client with pulmonary edema. Notifying the healthcare provider is important but not the priority when the client's respiratory status is deteriorating.

5. A client being seen in the emergency department for complaints of chest pain confides in the nurse about regular use of cocaine as a recreational drug. The nurse takes which important action in delivering holistic nursing care to this client?

• A. Reports the client to the police for illegal drug use
• B. Explains to the client the damage that cocaine does to the heart
• C. Tells the client it is imperative to stop before myocardial infarction occurs
• D. Teaches about the effects of cocaine on the heart and offers a referral for further help

Correct answer: D

Rationale: In this scenario, the nurse should prioritize educating the client about the effects of cocaine on the heart and provide a referral for further help. This approach is crucial in addressing the root cause of the client's health issues and supporting them in making informed decisions about their health. Reporting the client to the police is not appropriate in this situation as the focus should be on the client's health and well-being. Simply explaining the damage without offering solutions may not effectively address the client's needs or promote holistic care. Telling the client to stop without providing support or education may not be as effective as teaching about the effects of cocaine and offering help for cessation. Therefore, educating about the effects and providing a referral for further assistance is the best course of action for holistic nursing care.

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