Nursing Elites

1. A nurse is caring for a client who has hypertension and is receiving enalapril. Which of the following findings should the nurse report to the provider?

• A. Increased heart rate
• B. Persistent cough
• C. Constipation
• D. Sweating

Correct answer: B

Rationale: The correct answer is B: Persistent cough. Enalapril is an ACE inhibitor that can cause a persistent cough as a common side effect. This symptom should be reported to the healthcare provider to evaluate if a medication adjustment is needed. Choices A, C, and D are not typically associated with enalapril use and are less likely to be directly related to the medication. Increased heart rate, constipation, and sweating are not commonly linked to enalapril, so they are not the priority findings to report in this case.

2. What are the common complications of diabetes, and how should they be managed?

• A. Retinopathy and nephropathy; manage with regular screening
• B. Neuropathy and cardiovascular disease; manage with medication
• C. Foot ulcers and hypertension; manage with proper foot care
• D. Hypertension and liver disease; manage with insulin therapy

Correct answer: A

Rationale: The correct answer is A. Common complications of diabetes include retinopathy (damage to the retina) and nephropathy (kidney damage). These complications can be managed effectively with regular screening to detect any signs early on. Choice B is incorrect as neuropathy and cardiovascular disease are other complications of diabetes but are managed through various treatments and lifestyle modifications, not just medication. Choice C is incorrect as although foot ulcers and hypertension are associated with diabetes, the management involves proper foot care practices and blood pressure control, respectively. Choice D is incorrect as hypertension and liver disease are not the typical complications of diabetes, and insulin therapy is not the primary management for these conditions.

3. What are the key interventions for managing pneumonia?

• A. Administer antibiotics and monitor oxygen levels
• B. Administer bronchodilators and encourage deep breathing
• C. Provide fluids and monitor for dehydration
• D. Administer oxygen and provide bed rest

Correct answer: A

Rationale: The correct answer is A: Administer antibiotics and monitor oxygen levels. Antibiotics are essential to treat the infection caused by bacteria in pneumonia, while monitoring oxygen levels helps ensure adequate oxygenation. Administering bronchodilators and encouraging deep breathing, as in choice B, are more commonly associated with managing conditions like asthma or COPD, not pneumonia. Providing fluids and monitoring for dehydration, as in choice C, are important for various conditions but not specific to pneumonia management. Administering oxygen and providing bed rest, as in choice D, may be supportive measures in pneumonia treatment, but the key intervention is administering antibiotics.

4. What are the early signs of sepsis in a patient?

• A. Increased heart rate and fever
• B. Low blood pressure and confusion
• C. Elevated blood sugar and sweating
• D. Increased urine output and abdominal pain

Correct answer: A

Rationale: The correct answer is A: Increased heart rate and fever. These are early signs of sepsis and indicate a systemic infection. It is crucial to identify these signs promptly to initiate appropriate treatment. Choice B is incorrect because low blood pressure and confusion are more indicative of severe sepsis or septic shock rather than early signs. Choice C is incorrect as elevated blood sugar and sweating are not typical early signs of sepsis. Choice D is also incorrect as increased urine output and abdominal pain are not early signs of sepsis.

5. A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following interventions should the nurse include in the plan of care?

• A. Monitor the client's temperature every 4 hours
• B. Monitor blood glucose levels every 6 hours
• C. Administer insulin as prescribed
• D. Monitor daily fluid intake

Correct answer: B

Rationale: Corrected Rationale: Monitoring blood glucose levels is crucial in clients receiving TPN because the solution has a high glucose content. This monitoring helps prevent hyperglycemia and allows for timely adjustments in the TPN formulation if needed. Monitoring the client's temperature (Choice A) is not directly related to TPN administration. Administering insulin (Choice C) should be based on blood glucose levels and the healthcare provider's orders; it is not a standard intervention for all clients on TPN. Monitoring daily fluid intake (Choice D) is important for overall fluid balance but is not as critical as monitoring blood glucose levels specifically for clients on TPN.

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