Nursing Elites

1. A nurse is caring for a client with a new prescription for metoprolol. Which of the following should the nurse monitor?

• A. Blood pressure
• B. Liver function
• C. Serum potassium levels
• D. Blood glucose

Correct answer: A

Rationale: Corrected Rationale: Metoprolol is a beta-blocker commonly used to treat conditions like hypertension and angina. As a beta-blocker, it primarily affects the cardiovascular system by reducing heart rate and blood pressure. Therefore, the nurse should monitor the client's blood pressure regularly to assess the drug's effectiveness and ensure that it is within the therapeutic range. Monitoring liver function, serum potassium levels, or blood glucose is not typically required for clients taking metoprolol, as its primary impact is on the heart and blood vessels, making choice A the most appropriate monitoring parameter.

2. A nurse is caring for a client with congestive heart failure. Which of the following prescriptions should the nurse anticipate?

• A. Call the provider if the respiratory rate is less than 18/min
• B. Administer a 500 mL IV bolus of 0.9% sodium chloride over 1 hour
• C. Administer enalapril 2.5 mg PO twice daily
• D. Call the provider if the client’s pulse rate is less than 80/min

Correct answer: C

Rationale: Enalapril, an ACE inhibitor, is commonly prescribed to manage hypertension and heart failure. It helps reduce the workload on the heart and prevent fluid retention. Options A, B, and D are incorrect. Option A focuses on a respiratory rate, which is not specific to heart failure management. Option B suggests administering a large IV bolus of fluid, which can worsen heart failure by increasing fluid volume. Option D addresses the pulse rate, which is not a typical parameter to monitor for heart failure specifically.

3. A client has been prescribed enoxaparin. Which of the following instructions should the nurse provide regarding self-administration?

• A. Pinch the skin and inject at a 45-degree angle
• B. Massage the injection site after administering
• C. Administer at a 90-degree angle
• D. Avoid rotating injection sites

Correct answer: A

Rationale: The correct answer is to pinch the skin and inject at a 45-degree angle when administering enoxaparin. This technique helps ensure proper administration of the medication. Massaging the injection site after administering is unnecessary and could increase the risk of bleeding. Administering at a 90-degree angle is not recommended for enoxaparin injections. Rotating injection sites is important to prevent tissue damage and irritation.

4. A nurse is assisting with meal planning for a client who has been prescribed a mechanical soft diet. The nurse should instruct the client to avoid which of the following foods?

• A. Applesauce
• B. Mashed potatoes
• C. Orange slices
• D. Soft bread

Correct answer: C

Rationale: The correct answer is C: Orange slices. Orange slices contain membranes that are difficult to swallow, which can pose a risk to clients on a mechanical soft diet. This type of diet is designed for individuals who have difficulty chewing or swallowing. Choices A, B, and D are suitable for a mechanical soft diet as they are soft in texture and easy to chew and swallow.

5. What is an example of a culturally sensitive response from a healthcare provider when a patient mentions feeling uncomfortable with a treatment plan?

• A. Asking why they feel this way
• B. Explaining that the treatment is standard
• C. Inviting the patient to share concerns
• D. Offering alternative treatments

Correct answer: C

Rationale: Inviting the patient to share concerns is an example of a culturally sensitive response as it acknowledges the patient's feelings and provides a safe space for them to express their discomfort. This approach shows respect for the patient's cultural beliefs and values by valuing their perspective. Choice A, asking why they feel this way, can be perceived as confrontational and may not encourage open communication. Choice B, explaining that the treatment is standard, dismisses the patient's feelings and does not address their discomfort. Choice D, offering alternative treatments, may be premature without fully understanding the patient's concerns first.

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