Nursing Elites

1. A nurse is caring for a client who has a new prescription for enalapril. Which of the following findings should the nurse identify as an adverse effect of the medication?

• A. Cough.
• B. Dry mouth.
• C. Urinary retention.
• D. Insomnia.

Correct answer: A

Rationale: Corrected Rationale: A persistent cough is a known adverse effect of enalapril, an ACE inhibitor. Enalapril can cause the accumulation of bradykinin, leading to a dry, persistent cough in some patients. Dry mouth (choice B) and urinary retention (choice C) are not typically associated with enalapril use. Insomnia (choice D) is also not a common adverse effect of enalapril. Therefore, the correct answer is A.

2. A client who has a new prescription for spironolactone is being taught by a nurse. Which of the following client statements indicates an understanding of the teaching?

• A. I will avoid foods that are high in potassium.
• B. I will avoid foods that are high in sodium.
• C. I will need to have my blood pressure checked regularly while taking this medication.
• D. I will need to have my potassium levels checked regularly while taking this medication.

Correct answer: D

Rationale: The correct answer is D because clients taking spironolactone should have their potassium levels checked regularly. Spironolactone is a potassium-sparing diuretic, meaning it helps the body retain potassium and can lead to hyperkalemia if levels become too high. Choices A, B, and C are incorrect because avoiding foods high in potassium, sodium, or monitoring blood pressure are not specific to the teaching related to spironolactone.

3. A nurse is caring for a client who has acute pancreatitis. Which of the following laboratory results should the nurse expect to be elevated?

• A. Serum creatinine.
• B. Amylase.
• C. Hemoglobin.
• D. Blood glucose.

Correct answer: B

Rationale: The correct answer is B: Amylase. Amylase is typically elevated in clients with acute pancreatitis due to inflammation of the pancreas. Elevated serum creatinine levels are more indicative of kidney dysfunction rather than pancreatitis. Hemoglobin levels are not directly related to pancreatitis. While blood glucose levels can be affected by pancreatitis, they are not typically the primary laboratory result expected to be elevated in this condition.

4. A nurse is preparing to administer digoxin to a client who has heart failure. Which of the following findings should the nurse report to the provider?

• A. Potassium 4.0 mEq/L
• B. Calcium 9.5 mg/dL
• C. Heart rate of 60/min
• D. Sodium 140 mEq/L

Correct answer: C

Rationale: The correct answer is C: Heart rate of 60/min. A heart rate of 60/min is borderline bradycardia, which can be a sign of digoxin toxicity. Digoxin can cause bradycardia, so any further decrease in heart rate should be reported promptly to the healthcare provider. Choices A, B, and D are within the normal range and not specifically related to potential digoxin toxicity, so they do not require immediate reporting.

5. A nurse is preparing to administer an intermittent enteral feeding to a client who has a nasogastric tube. Which of the following actions should the nurse take?

• A. Check for residual feeding contents.
• B. Administer the feeding through a large-bore syringe.
• C. Flush the tube with 10 mL of water after feeding.
• D. Administer the feeding at room temperature.

Correct answer: C

Rationale: The correct action for the nurse to take when preparing to administer an intermittent enteral feeding through a nasogastric tube is to flush the tube with 10 mL of water after feeding. This helps maintain tube patency and prevent clogging. Choice A, checking for residual feeding contents, is not the immediate action to take before administering the feeding. Choice B, administering the feeding through a large-bore syringe, is not the recommended method for administering enteral feedings. Choice D, administering the feeding at room temperature, is important but not the immediate action related to tube maintenance.

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