Nursing Elites

1. A client has a new prescription for verapamil. Which of the following beverages should the client avoid while taking this medication?

• A. Orange juice
• B. Coffee
• C. Milk
• D. Grapefruit juice

Correct answer: D

Rationale: Grapefruit juice should be avoided while taking verapamil as it can increase drug levels and the risk of side effects. The interaction between grapefruit juice and verapamil can lead to higher concentrations of the medication in the bloodstream, potentially causing adverse effects. Orange juice, coffee, and milk do not have significant interactions with verapamil. Therefore, it is crucial for the client to avoid grapefruit juice to ensure the safe and effective use of verapamil.

2. The healthcare provider is monitoring a client following cardioversion. Which observation should be of the highest priority to the healthcare provider?

• A. Blood pressure
• B. Status of airway
• C. Oxygen flow rate
• D. Level of consciousness

Correct answer: B

Rationale: The status of the airway is the highest priority following cardioversion as it ensures proper oxygenation and helps prevent complications such as airway obstruction and respiratory distress. Maintaining a patent airway is crucial for the client's respiratory function and overall well-being immediately after cardioversion. Monitoring the airway ensures that the client can breathe effectively and minimizes the risk of hypoxia and other serious respiratory issues. While blood pressure, oxygen flow rate, and level of consciousness are also important parameters to monitor, they are secondary to ensuring a clear and patent airway for adequate oxygenation.

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

• A. Store the medication in a cool, dry place.
• B. Take the medication as directed by the healthcare provider.
• C. Take the medication 30 minutes before meals.
• D. Take the medication at the first sign of chest pain.

Correct answer: D

Rationale: Instructing the client to take nitroglycerin at the first sign of chest pain is crucial for immediate relief of angina symptoms. Nitroglycerin is a fast-acting medication that helps dilate blood vessels, improving blood flow to the heart muscle. Therefore, prompt administration at the onset of chest pain is essential to alleviate anginal episodes effectively. Choices A, B, and C are incorrect because storing the medication properly, taking it as directed, or before meals are not specific instructions for managing acute anginal episodes, which require immediate action for symptom relief.

5. A client has a history of left-sided heart failure. The nurse should look for the presence of which finding to determine whether the problem is currently active?

• A. Presence of ascites
• B. Bilateral lung crackles
• C. Jugular vein distention
• D. Pedal edema bilaterally

Correct answer: B

Rationale: When assessing a client with a history of left-sided heart failure, the presence of bilateral lung crackles is a key finding to determine if the condition is currently active. Crackles in the lungs indicate fluid accumulation, a common sign of left-sided heart failure due to pulmonary congestion. Choices A, C, and D are incorrect because ascites, jugular vein distention, and pedal edema are more commonly associated with right-sided heart failure.

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