Nursing Elites

1. A client on an ACE inhibitor reports a persistent cough. What is the nurse’s best response?

• A. Reassure the client that the cough is a common side effect and is usually not serious.
• B. Instruct the client to report the cough to the healthcare provider as it may require discontinuation of the medication.
• C. Advise the client to use a humidifier at night to relieve the cough.
• D. Suggest the client take an over-the-counter cough suppressant.

Correct answer: B

Rationale: The correct answer is B. A persistent cough in a client on an ACE inhibitor may indicate a serious side effect that requires discontinuation of the medication. Instructing the client to report the cough to the healthcare provider is essential for proper evaluation and management. Choice A is incorrect because simply reassuring the client may delay necessary action. Choice C is incorrect as using a humidifier may not address the underlying cause of the cough. Choice D is incorrect because taking a cough suppressant without healthcare provider guidance may mask symptoms without addressing the cause.

2. The healthcare provider is monitoring a client on an ACE inhibitor. What lab value is most important to monitor?

• A. Potassium
• B. Sodium
• C. Creatinine
• D. Calcium

Correct answer: A

Rationale: The correct answer is A: Potassium. When a client is on an ACE inhibitor, it is crucial to monitor potassium levels because ACE inhibitors can lead to an increase in potassium, potentially causing hyperkalemia. Monitoring sodium levels (Choice B) is not as critical in this scenario. Creatinine levels (Choice C) are important for assessing kidney function but are not the most crucial lab value to monitor with ACE inhibitors. Calcium levels (Choice D) are not directly affected by ACE inhibitors and are not the priority for monitoring in this case.

3. Which type of lung cancer begins in the cells lining the bronchi and bronchioles?

• A. Adenocarcinoma
• B. Small cell lung cancer
• C. Squamous cell carcinoma
• D. Mesothelioma

Correct answer: A

Rationale: Adenocarcinoma is the correct answer because it is a type of lung cancer that originates in the cells lining the bronchi and bronchioles. Adenocarcinoma is one of the most common types of lung cancer, often found in non-smokers and more frequently in women. Small cell lung cancer (Choice B) typically starts in the bronchi, but it is characterized by its rapid growth and tendency to spread quickly. Squamous cell carcinoma (Choice C) usually begins in the squamous cells lining the bronchi and is strongly associated with smoking. Mesothelioma (Choice D) is a cancer that affects the lining of certain organs like the lungs, often caused by asbestos exposure, but it does not specifically start in the cells lining the bronchi and bronchioles.

4. The client on furosemide (Lasix) has a potassium level of 3.1 mEq/L. What is the nurse’s priority action?

• A. Administer a potassium supplement.
• B. Hold the furosemide and notify the healthcare provider.
• C. Continue the current dose of furosemide.
• D. Administer Digibind.

Correct answer: A

Rationale: The correct answer is to administer a potassium supplement. A potassium level of 3.1 mEq/L indicates hypokalemia, which can lead to serious complications like cardiac dysrhythmias. Therefore, the priority action is to address the low potassium level by administering a potassium supplement. Holding the furosemide (Choice B) may be necessary in the long term to prevent further potassium loss, but the immediate need is to correct the low potassium level. Continuing the current dose of furosemide (Choice C) without addressing the low potassium level can worsen hypokalemia. Administering Digibind (Choice D) is not indicated for low potassium levels; Digibind is used to treat digoxin toxicity.

5. Which condition is characterized by the narrowing or blockage of arteries that supply blood to the heart by plaque?

• A. Coronary artery disease (CAD)
• B. Atherosclerosis
• C. Peripheral artery disease
• D. Congestive heart failure

Correct answer: A

Rationale: The correct answer is A, Coronary artery disease (CAD). CAD specifically refers to the condition where the arteries supplying blood to the heart become narrowed or blocked by plaque buildup. Choice B, Atherosclerosis, is a general term for the hardening and narrowing of arteries due to plaque buildup but does not specifically mention the heart. Choice C, Peripheral artery disease, involves narrowing of arteries that supply blood to areas other than the heart. Choice D, Congestive heart failure, is a condition where the heart is unable to pump blood effectively but is not primarily caused by narrowed or blocked arteries.

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