Nursing Elites

1. A patient with chronic heart failure is prescribed carvedilol. What is the primary purpose of this medication?

• A. Increase cardiac output
• B. Reduce fluid retention
• C. Decrease heart rate
• D. Lower blood pressure

Correct answer: C

Rationale: Carvedilol, a beta-blocker, is primarily prescribed in patients with chronic heart failure to decrease heart rate and reduce the workload on the heart. By lowering the heart rate, carvedilol helps the heart function more efficiently and improves symptoms in patients with heart failure.

2. The mother of a 9-month-old who was diagnosed with respiratory syncytial virus (RSV) yesterday calls the clinic to inquire if it will be all right to take her infant to the first birthday party of a friend's child the following day. What response should the nurse provide this mother?

• A. The child can be around other children but should wear a mask at all times.
• B. The child will no longer be contagious, no need to take any further precautions.
• C. Make sure there are no children under the age of 6 months around the infected child.
• D. Do not expose other children. RSV is very contagious even without direct oral contact.

Correct answer: D

Rationale: The correct response is to advise the mother not to expose other children to the infected child. RSV is highly contagious, and transmission can occur even without direct oral contact. It is crucial to prevent the spread of the virus to protect other children from getting infected.

3. A 56-year-old white male complains of intermittent dysphagia for the past three months, particularly with the ingestion of meat. He has no difficulties swallowing liquids. He has no history of smoking, uses no medications, and has had no weight loss. What test would be best to evaluate him?

• A. Upper endoscopy
• B. Chest/abdominal CT scan
• C. Barium swallow
• D. Esophageal manometry

Correct answer: C

Rationale: For a patient presenting with intermittent dysphagia, especially with solids like meat, a barium swallow is the most appropriate initial test. In this case, the classic presentation suggests a Schatzki’s ring, which is best visualized through a barium study. Upper endoscopy may not always visualize Schatzki’s rings effectively. Chest/abdominal CT scan and esophageal manometry are not the preferred tests for diagnosing Schatzki’s rings. Treatment for Schatzki’s rings often involves bougie dilatation, and no further therapy may be necessary.

4. What action should the healthcare provider take to reduce the risk of vesicant extravasation in a client receiving intravenous chemotherapy?

• A. Administer an antiemetic before starting the chemotherapy.
• B. Instruct the client to drink plenty of fluids during the treatment.
• C. Keep the head of the bed elevated until the treatment is completed.
• D. Monitor the client's intravenous site hourly during the treatment.

Correct answer: D

Rationale: Monitoring the intravenous site hourly is essential to identify early signs of extravasation, such as swelling or pain, which can help prevent tissue damage. Prompt detection allows for immediate intervention, minimizing the risk of serious complications associated with vesicant extravasation.

5. When teaching a client postoperative breathing techniques with an incentive spirometer (IS), what should the nurse encourage the client to do to maintain sustained maximal inspiration?

• A. Exhale forcefully into the tubing for 3 to 5 seconds.
• B. Inspire deeply and slowly over 3 to 5 seconds.
• C. Breathe into the spirometer using normal breath volumes.
• D. Perform IS breathing exercises every 6 hours.

Correct answer: B

Rationale: To maintain sustained maximal inspiration when using an incentive spirometer, the client should be encouraged to inspire deeply and slowly over 3 to 5 seconds. This technique aids in achieving the goal of sustained maximal inspiration, which is essential for postoperative respiratory recovery.

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