Nursing Elites

1. The client is on enalapril (Vasotec) for hypertension. What side effect is most commonly associated with this medication?

• A. Dry cough
• B. Hypotension
• C. Hyperkalemia
• D. Headache

Correct answer: A

Rationale: The correct answer is A: Dry cough. A dry cough is a common side effect of ACE inhibitors like enalapril. ACE inhibitors can cause the accumulation of bradykinin, leading to irritation of the respiratory tract and resulting in a persistent dry cough. Hypotension (choice B) is a possible side effect of ACE inhibitors but is less common than a dry cough. Hyperkalemia (choice C) is another side effect of ACE inhibitors, but it is not the most commonly associated one. Headache (choice D) is not a common side effect of enalapril compared to a dry cough. Therefore, the most commonly associated side effect with enalapril is a dry cough.

2. The client on spironolactone should avoid which of the following?

• A. Foods high in potassium
• B. Foods high in sodium
• C. Foods high in calcium
• D. Foods high in chloride

Correct answer: A

Rationale: The correct answer is A: Foods high in potassium. Spironolactone is a potassium-sparing diuretic, meaning it helps the body retain potassium and excrete sodium. Consuming foods high in potassium while on spironolactone can lead to an excess of potassium in the body, potentially causing hyperkalemia. Choices B, C, and D are incorrect because spironolactone does not directly interact with sodium, calcium, or chloride in a way that would require specific dietary restrictions related to these minerals.

3. The client on warfarin has an INR of 4.5. What is the most appropriate action by the nurse?

• A. Administer vitamin K.
• B. Hold the next dose of warfarin.
• C. Increase the dose of warfarin.
• D. Monitor the client’s INR closely.

Correct answer: A

Rationale: An INR of 4.5 is elevated, indicating an increased risk of bleeding due to excessive anticoagulation. The most appropriate action for the nurse in this scenario is to administer vitamin K. Vitamin K helps reverse the anticoagulant effects of warfarin, thus lowering the INR and reducing the risk of bleeding. Holding the next dose of warfarin (choice B) is not sufficient to address the immediate high INR level. Increasing the dose of warfarin (choice C) would further elevate the INR, worsening the risk of bleeding. While monitoring the client's INR closely (choice D) is important, immediate action is required to address the critically high INR level, making the administration of vitamin K the priority intervention.

4. Which term refers to a condition where the blood supply to part of the heart muscle is blocked, often referred to as a heart attack?

• A. Myocardial infarction
• B. Arrhythmia
• C. Stroke
• D. Aneurysm

Correct answer: A

Rationale: The correct answer is A, myocardial infarction. A myocardial infarction, commonly known as a heart attack, occurs when the blood supply to part of the heart muscle is blocked, often by a blood clot. Choices B, C, and D are incorrect because arrhythmia refers to an irregular heartbeat, stroke involves the interruption of blood flow to the brain, and an aneurysm is a bulge in a blood vessel.

5. Which condition is an infection that inflames the air sacs in one or both lungs, which may fill with fluid?

• A. Pneumonia
• B. Bronchitis
• C. Tuberculosis
• D. Cystic fibrosis

Correct answer: A

Rationale: The correct answer is A, Pneumonia. Pneumonia is an infection that inflames the air sacs in the lungs, which may fill with fluid or pus, causing symptoms like cough, fever, and difficulty breathing. Bronchitis (choice B) is an inflammation of the bronchial tubes, not the air sacs in the lungs. Tuberculosis (choice C) is a bacterial infection that primarily affects the lungs but does not always cause fluid accumulation in the air sacs. Cystic fibrosis (choice D) is a genetic disorder that affects the lungs but does not directly cause inflammation of the air sacs with fluid.

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