Nursing Elites

1. The client's B-type natriuretic peptide (BNP) level is 691 pg/mL. Which intervention should the nurse implement when providing care for the client?

• A. Take daily weights and monitor trends.
• B. Encourage fluid intake to improve hydration.
• C. Elevate the legs above the level of the heart.
• D. Position the client supine with the head of the bed at 30 degrees.

Correct answer: A

Rationale: Elevated BNP levels are indicative of heart failure, which often causes fluid retention and weight gain. Taking daily weights and monitoring trends allows the nurse to assess for changes in fluid status. This intervention helps in evaluating the effectiveness of the treatment plan and identifying worsening heart failure symptoms early. Encouraging fluid intake (Choice B) might exacerbate fluid overload in a client with elevated BNP levels. Elevating the legs (Choice C) and positioning the client supine with the head of the bed at 30 degrees (Choice D) are interventions more suitable for clients with hypotension, not specifically indicated for managing elevated BNP levels.

2. A nurse is assessing a client who has a new prescription for albuterol. Which of the following findings should the nurse report to the provider?

• A. Dry mouth
• B. Tachycardia
• C. Weight gain
• D. Drowsiness

Correct answer: B

Rationale: The correct answer is B: Tachycardia. Albuterol is a bronchodilator medication commonly used to treat respiratory conditions such as asthma. Tachycardia, an increased heart rate, can be a potential side effect of albuterol, indicating excessive stimulation of the beta receptors. This side effect should be reported to the healthcare provider promptly to assess the need for further intervention or adjustment of the treatment plan. Choices A, C, and D are incorrect because dry mouth, weight gain, and drowsiness are not typically associated with albuterol use and are less likely to require immediate reporting compared to tachycardia.

3. A nurse is assessing a client who has been taking phenytoin for epilepsy. Which of the following findings should the nurse report to the provider?

• A. Weight loss
• B. Gingival hyperplasia
• C. Increased thirst
• D. Frequent urination

Correct answer: B

Rationale: The correct answer is B: Gingival hyperplasia. Phenytoin is known to cause gingival hyperplasia, an overgrowth of gum tissue, which can lead to oral health issues and requires dental care. Choices A, C, and D are not directly associated with phenytoin use. Weight loss, increased thirst, and frequent urination are not typically reported findings related to phenytoin and should not be prioritized over gingival hyperplasia when assessing a client taking this medication.

4. When assessing a client receiving total parenteral nutrition (TPN), which laboratory value is most important for the nurse to monitor regularly?

• A. Albumin
• B. Calcium
• C. Glucose
• D. Alkaline phosphatase

Correct answer: C

Rationale: The most important laboratory value to monitor regularly in clients receiving total parenteral nutrition (TPN) is glucose. TPN solutions contain high concentrations of glucose, which can lead to hyperglycemia. Monitoring glucose levels is crucial to detect and prevent hyperglycemia, a common complication associated with TPN administration. Albumin (Choice A) levels are not typically affected by TPN administration. Calcium (Choice B) and alkaline phosphatase (Choice D) are not directly impacted by TPN and are not the primary values to monitor in TPN therapy.

5. The client has angina pectoris and is prescribed nitroglycerin patches. What instruction should the nurse provide to the client?

• A. Apply the patch to the chest and leave it in place for 24 hours
• B. Apply the patch to a different site each time to prevent skin irritation
• C. Remove the patch before going to bed to prevent tolerance
• D. Cut the patch in half if experiencing headaches

Correct answer: B

Rationale: The correct instruction for the nurse to provide to the client is to apply the nitroglycerin patch to a different site each time to prevent skin irritation. Rotating the application site is crucial to prevent skin irritation and ensure consistent absorption of the medication. Applying the patch to the same site can lead to skin irritation and decreased effectiveness. Removing the patch before going to bed is not necessary, as the patch can typically be worn for a specific duration. Cutting the patch in half if experiencing headaches is not recommended and can alter the dose of the medication.

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