Nursing Elites

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

• A. Monitor blood pressure daily.
• B. Take the medication with food.
• C. Increase intake of potassium-rich foods.
• D. Avoid consuming grapefruit juice.

Correct answer: A

Rationale: The correct answer is to instruct the client to monitor their blood pressure daily. Lisinopril is known to cause hypotension, so monitoring blood pressure regularly is essential to detect any potential issues early on. Choice B is incorrect as lisinopril is usually taken on an empty stomach. Choice C is incorrect as lisinopril can increase potassium levels, so additional intake of potassium-rich foods may lead to hyperkalemia. Choice D is incorrect because grapefruit juice can interact with lisinopril, leading to adverse effects.

2. The client with chronic stable angina is prescribed a beta blocker. The nurse is reinforcing instructions. What instruction should the nurse include?

• A. Take the medication with a meal.
• B. Report a pulse rate below 60 beats per minute.
• C. Discontinue the medication if dizziness occurs.
• D. Avoid drinking grapefruit juice.

Correct answer: B

Rationale: The correct instruction for the nurse to include is to advise the client to report a pulse rate below 60 beats per minute. Beta blockers are known to lower heart rate, and a pulse rate below 60 beats per minute may indicate bradycardia, a condition that requires medical attention. Option A, 'Take the medication with a meal,' is incorrect because beta blockers don't necessarily need to be taken with food. Option C, 'Discontinue the medication if dizziness occurs,' is incorrect because abrupt cessation of beta blockers can lead to rebound hypertension and other adverse effects. Option D, 'Avoid drinking grapefruit juice,' is unrelated to beta blockers' mechanism of action or side effects.

3. The healthcare provider is setting up the bedside unit for a client being admitted to the nursing unit from the emergency department with a diagnosis of coronary artery disease (CAD). The provider should place the highest priority on making sure that which is available at the bedside?

• A. Bedside commode
• B. Rolling shower chair
• C. Oxygen tubing and flowmeter
• D. Twelve-lead electrocardiogram (ECG) machine

Correct answer: C

Rationale: In a client with coronary artery disease (CAD), ensuring the availability of oxygen and a flowmeter at the bedside is crucial. Oxygen is essential for adequate oxygenation, which helps prevent myocardial ischemia, a common complication in CAD. The other options, such as a bedside commode and rolling shower chair, are important for patient comfort and mobility but are not as critical as ensuring proper oxygen supply in a client with CAD. While having an ECG machine available is important for ongoing monitoring, ensuring oxygen availability takes precedence in this scenario.

4. A client with a history of coronary artery disease (CAD) is being discharged after angioplasty. Which instruction should the LPN/LVN reinforce to the client?

• A. You should report any chest pain or discomfort to your health care provider.
• B. Avoid all physical activity for the next 2 weeks.
• C. Return to work immediately after discharge.
• D. Take aspirin only if you experience chest pain.

Correct answer: A

Rationale: The correct instruction to reinforce is to 'Report any chest pain or discomfort to your health care provider.' This is crucial because chest pain post-angioplasty can indicate complications that need immediate attention. Choice A is incorrect because returning to work immediately may not be advisable after angioplasty, as the client needs time to recover. Choice B is incorrect because avoiding all physical activity for 2 weeks may not be necessary; instead, gradual resumption of activities is usually recommended. Choice D is incorrect because aspirin should be taken as prescribed by the healthcare provider, not just when chest pain occurs.

5. A healthcare professional is assessing a client who is taking levodopa/carbidopa. Which of the following findings should the healthcare professional report to the provider?

• A. Weight gain
• B. Urinary retention
• C. Bradykinesia
• D. Dry mouth

Correct answer: C

Rationale: Corrected Rationale: Bradykinesia is a cardinal symptom of Parkinson's disease characterized by slowness of movement. An increase in bradykinesia may indicate a worsening of the disease and the need for adjustments in medication or other interventions. Therefore, it is crucial for the healthcare professional to report this finding to the provider promptly for further evaluation and management. Weight gain, urinary retention, and dry mouth are not directly associated with levodopa/carbidopa therapy or indicative of a worsening condition in Parkinson's disease, making them less urgent findings to report to the provider.

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