Nursing Elites

1. A client is prescribed Nitroglycerin sublingual tablets. Which of the following instructions should the nurse include during discharge teaching?

• A. Take the medication with food.
• B. Store the medication in a cool, dry place.
• C. Swallow the tablets whole.
• D. Take one tablet every 5 minutes up to three doses for chest pain.

Correct answer: D

Rationale: During a chest pain episode, the client should take one nitroglycerin tablet sublingually every 5 minutes up to a total of three doses. If chest pain persists after three doses, emergency medical attention should be sought. Nitroglycerin should not be swallowed but allowed to dissolve under the tongue for rapid absorption. Storing the medication in a cool, dry place helps maintain its effectiveness.

2. A hospitalized client has an activated partial thromboplastin time (aPTT) greater than 1.5 times the expected reference range. Which of the following blood products should be prepared for transfusion?

• A. Whole blood
• B. Platelets
• C. Fresh frozen plasma
• D. Packed red blood cells

Correct answer: C

Rationale: Fresh frozen plasma is the appropriate blood product for a client with an elevated aPTT as it contains various coagulation factors that can help correct coagulopathies and prevent bleeding. Elevated aPTT indicates a deficiency in specific clotting factors, and fresh frozen plasma is rich in these factors. Whole blood, platelets, and packed red blood cells do not contain the necessary coagulation factors to correct an elevated aPTT, so they are not indicated in this situation.

3. When educating a client with a new prescription for Enalapril, which manifestation should the nurse instruct the client to report as an adverse effect of this medication?

• A. Tremors
• B. Dry cough
• C. Drowsiness
• D. Hyperactivity

Correct answer: B

Rationale: A persistent dry cough is a well-known adverse effect of ACE inhibitors, such as enalapril. This cough can be bothersome and may indicate the need for a medication adjustment. It is crucial for the client to report this symptom to their healthcare provider to explore potential alternatives or adjustments to the treatment plan. Tremors, drowsiness, and hyperactivity are not commonly associated with enalapril and are less likely to be attributed to this medication.

4. A healthcare professional is administering a Dopamine infusion at a low dose to a client with severe heart failure. Which of the following findings is an expected effect of this medication?

• A. Lowered heart rate
• B. Increased myocardial contractility
• C. Decreased conduction through the AV node
• D. Vasoconstriction of renal blood vessels

Correct answer: B

Rationale: Dopamine, when administered at a low dose, is expected to increase myocardial contractility by stimulating beta1 receptors. This positive inotropic effect leads to an increase in cardiac output. Therefore, the correct answer is increased myocardial contractility, as it is a desired effect of administering dopamine to a client with severe heart failure.

5. When administering Lithium to a patient, what is a life-threatening side effect?

• A. Erythema
• B. Pancreatitis
• C. Seizures
• D. Headache

Correct answer: C

Rationale: When a patient is being treated with Lithium, a life-threatening side effect to watch out for is seizures. Lithium can lower the seizure threshold, increasing the risk of seizures. Seizures are serious and necessitate prompt medical intervention to ensure the patient's safety and well-being. Erythema, which is redness of the skin, is not a common life-threatening side effect of Lithium. Pancreatitis can be a side effect of Lithium, but it is not typically life-threatening. Headache is a common side effect of Lithium, but it is not considered life-threatening.

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