Nursing Elites

1. A nurse is providing discharge teaching to a client who has a new prescription for lisinopril. Which of the following client statements indicates an understanding of the teaching?

• A. I may experience a persistent cough while taking this medication.
• B. I should take this medication with food.
• C. I should increase my intake of potassium-rich foods.
• D. I should stop taking this medication if I develop a headache.

Correct answer: A

Rationale: The correct answer is A: 'I may experience a persistent cough while taking this medication.' Lisinopril is known to cause a persistent cough as a common side effect. This statement indicates that the client understands the potential side effect associated with the medication. Choice B is incorrect because lisinopril is typically taken on an empty stomach. Choice C is incorrect as increasing potassium-rich foods without healthcare provider guidance can lead to hyperkalemia. Choice D is incorrect because a headache is not a common reason to stop taking lisinopril.

2. A client with a new diagnosis of systemic lupus erythematosus (SLE) is being cared for by a nurse. Which of the following findings should the nurse expect?

• A. Joint pain.
• B. Weight gain.
• C. Butterfly-shaped rash on the face.
• D. Increased appetite.

Correct answer: B

Rationale: The correct answer is B: Weight gain. Weight gain is a common finding in clients with systemic lupus erythematosus due to fluid retention. Joint pain (choice A) is also common in SLE but is not specific to fluid retention. A butterfly-shaped rash on the face (choice C) is a classic symptom of SLE but is not related to fluid retention. Increased appetite (choice D) is less likely in SLE compared to weight gain.

3. Which lab value should be closely monitored for a patient receiving heparin therapy?

• A. Monitor aPTT
• B. Monitor INR
• C. Monitor potassium levels
• D. Monitor sodium levels

Correct answer: A

Rationale: The correct answer is to monitor aPTT. Activated Partial Thromboplastin Time (aPTT) is crucial to monitor when a patient is receiving heparin therapy. Heparin works by potentiating antithrombin III, leading to the inhibition of thrombin and factor Xa. Monitoring aPTT helps ensure the patient is within the therapeutic range for heparin, reducing the risk of bleeding complications. Monitoring INR (Choice B) is more relevant for patients on warfarin therapy. Monitoring potassium (Choice C) and sodium levels (Choice D) is important but not specific to heparin therapy.

4. What is the most appropriate intervention for a patient with a suspected stroke?

• A. Administer IV fluids
• B. Perform a CT scan
• C. Perform a lumbar puncture
• D. Administer anticoagulants

Correct answer: B

Rationale: The most appropriate intervention for a patient with a suspected stroke is to perform a CT scan. A CT scan is crucial for diagnosing a stroke by visualizing any bleeding or blockages in the brain. Administering IV fluids (Choice A) may be necessary based on the patient's condition, but it is not the primary intervention for a suspected stroke. Performing a lumbar puncture (Choice C) is not indicated for stroke evaluation and may not provide relevant information. Administering anticoagulants (Choice D) is a treatment option for certain types of strokes but should be based on the CT scan results and specific guidelines.

5. A patient is 1 day postoperative following a hip arthroplasty. Which of the following actions should the nurse take to prevent dislocation of the hip?

• A. Keep the patient in a side-lying position.
• B. Place a pillow between the patient's legs.
• C. Instruct the patient to avoid sitting for long periods.
• D. Elevate the head of the bed to 90 degrees.

Correct answer: B

Rationale: Placing a pillow between the patient's legs is the correct action to prevent dislocation of the hip following arthroplasty. This technique helps maintain proper alignment and stability of the hip joint. Keeping the patient in a side-lying position may not provide the necessary support to prevent hip dislocation. Instructing the patient to avoid sitting for long periods is important for preventing complications like deep vein thrombosis but does not directly prevent hip dislocation. Elevating the head of the bed to 90 degrees is not relevant to preventing hip dislocation in a postoperative hip arthroplasty patient.

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