Nursing Elites

1. A client has a new prescription for furosemide. Which of the following statements should the nurse include in the teaching?

• A. Take the medication in the morning.
• B. Monitor for muscle weakness.
• C. Eat foods high in potassium.
• D. Expect weight gain.

Correct answer: C

Rationale: The correct statement that the nurse should include in the teaching for a client prescribed furosemide is to eat foods high in potassium. Furosemide can lead to potassium depletion (hypokalemia) due to increased urine output. Consuming potassium-rich foods like bananas, oranges, spinach, and potatoes can help prevent this electrolyte imbalance. Choices A, B, and D are incorrect because taking furosemide in the morning, monitoring for muscle weakness, and expecting weight gain are not directly related to the potential side effects or necessary dietary adjustments when taking furosemide.

2. The client is being taught about the use of sublingual nitroglycerin for chest pain. Which instruction should be provided?

• A. Swallow the tablet whole with water.
• B. Place the tablet under the tongue and let it dissolve.
• C. Chew the tablet and then swallow.
• D. Place the tablet between the cheek and gum.

Correct answer: B

Rationale: The correct method for administering sublingual nitroglycerin is to place the tablet under the tongue and allow it to dissolve. This route of administration facilitates rapid absorption of the medication into the bloodstream, enabling quick relief of chest pain associated with angina or heart conditions. Choice A is incorrect because sublingual nitroglycerin should not be swallowed whole. Choice C is wrong as chewing the tablet can lead to the rapid release of the drug, causing adverse effects like headaches or dizziness. Choice D is also incorrect as the tablet should not be placed between the cheek and gum, but under the tongue for proper absorption.

3. What preoperative instruction should the LPN/LVN reinforce to a client scheduled for a carotid endarterectomy?

• A. You will need to be NPO after midnight before the surgery.
• B. You should avoid deep breathing and coughing after the surgery.
• C. You will be able to eat and drink normally after the procedure.
• D. You can take all of your prescribed medications the morning of surgery.

Correct answer: A

Rationale: The correct preoperative instruction that the LPN/LVN should reinforce to a client scheduled for a carotid endarterectomy is being NPO after midnight before the surgery. This instruction is essential to prevent aspiration and ensure a safe procedure. Avoiding oral intake helps reduce the risk of complications during anesthesia induction and the surgical process. Choices B, C, and D are incorrect because avoiding deep breathing and coughing, resuming normal eating and drinking, and taking all prescribed medications the morning of surgery are not recommended preoperative instructions for a carotid endarterectomy.

4. The nurse is caring for a client diagnosed with deep vein thrombosis (DVT). Which intervention should the nurse include in the client's plan of care to prevent the complication of pulmonary embolism?

• A. Encourage ambulation as tolerated.
• B. Administer anticoagulants as prescribed.
• C. Apply cold compresses to the affected area.
• D. Encourage the use of incentive spirometry.

Correct answer: B

Rationale: Administering anticoagulants as prescribed is crucial in preventing the complication of pulmonary embolism in clients with deep vein thrombosis. Anticoagulants help prevent the formation of new clots and the enlargement of existing ones, thereby reducing the risk of a pulmonary embolism. Encouraging ambulation as tolerated is beneficial for preventing complications related to immobility, but it is not the primary intervention to prevent pulmonary embolism in this case. Applying cold compresses to the affected area may help with pain and swelling but does not address the prevention of pulmonary embolism. Encouraging the use of incentive spirometry is more relevant in preventing respiratory complications such as atelectasis, not specifically pulmonary embolism.

5. A client has a new prescription for levothyroxine. Which of the following instructions should the nurse include?

• A. Take the medication on an empty stomach.
• B. Take the medication with food.
• C. Take the medication at bedtime.
• D. Take the medication with an antacid.

Correct answer: A

Rationale: The correct answer is A: 'Take the medication on an empty stomach.' Levothyroxine should be taken on an empty stomach to ensure optimal absorption. Food, especially high-fiber foods, can interfere with the absorption of levothyroxine. Taking it with an antacid or at bedtime may also affect its absorption. Instructing the client to take the medication on an empty stomach will help maintain consistent blood levels of levothyroxine. Choice B is incorrect as taking levothyroxine with food can reduce its absorption. Choice C is incorrect because taking levothyroxine at bedtime may lead to inconsistent blood levels due to food intake during the day. Choice D is incorrect as antacids can interfere with the absorption of levothyroxine.

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