Nursing Elites

1. The nurse is assisting in the care of a client experiencing an acute myocardial infarction (MI). Which medication would the nurse expect to be administered to help reduce myocardial oxygen demand?

• A. Aspirin
• B. Morphine
• C. Atropine
• D. Lidocaine

Correct answer: B

Rationale: In the context of an acute myocardial infarction (MI), morphine is administered to relieve pain and reduce myocardial oxygen demand. By alleviating pain and anxiety, morphine helps reduce oxygen demand on the heart, which is beneficial in the setting of an MI. Aspirin, commonly used for its antiplatelet effects, helps inhibit platelet aggregation and is crucial in the management of MI to prevent further clot formation. Atropine is a medication used to treat symptomatic bradycardia by increasing heart rate, not commonly indicated in the management of acute MI. Lidocaine is used for ventricular dysrhythmias and is not typically given to reduce myocardial oxygen demand in an acute MI scenario.

2. A client with hypertension is prescribed metoprolol (Lopressor). The nurse should monitor the client for which side effect?

• A. Tachycardia
• B. Bradycardia
• C. Hypertension
• D. Hyperglycemia

Correct answer: B

Rationale: Metoprolol is a beta-blocker that works by slowing the heart rate. Therefore, the nurse should monitor the client for bradycardia, which is a potential side effect of metoprolol. Bradycardia refers to a heart rate that is slower than normal, and it can be a concern when administering medications like metoprolol that affect heart rate. Choices A, C, and D are incorrect as tachycardia (fast heart rate), hypertension (high blood pressure), and hyperglycemia (high blood sugar) are not typically associated with metoprolol use. In fact, metoprolol is used to treat hypertension and certain heart conditions by lowering heart rate and blood pressure.

3. The LPN/LVN is reinforcing discharge instructions to a client who has been prescribed nitroglycerin sublingual tablets for angina. Which statement by the client indicates a need for further teaching?

• A. I will keep my nitroglycerin tablets in the original glass bottle.
• B. I will sit or lie down when I take a nitroglycerin tablet.
• C. I will take a nitroglycerin tablet every 5 minutes if chest pain persists, up to a total of 3 tablets.
• D. I can swallow the nitroglycerin tablet with a glass of water if it does not dissolve quickly.

Correct answer: D

Rationale: The correct answer is D. Nitroglycerin sublingual tablets should not be swallowed; they must dissolve under the tongue to be effective. Choice A is correct as nitroglycerin tablets should be stored in their original glass container to prevent degradation. Choice B is correct as sitting or lying down when taking a nitroglycerin tablet helps prevent dizziness or fainting due to a sudden drop in blood pressure. Choice C is correct as taking a nitroglycerin tablet every 5 minutes for a maximum of 3 tablets is the correct protocol for managing angina symptoms.

4. When reinforcing dietary instructions to a client with coronary artery disease prescribed a low-fat, low-cholesterol diet, which food item should the nurse advise the client to choose?

• A. Whole milk
• B. Grilled salmon
• C. Fried chicken
• D. Bacon and eggs

Correct answer: B

Rationale: Grilled salmon is the correct choice for a client with coronary artery disease on a low-fat, low-cholesterol diet because it is low in saturated fat and high in omega-3 fatty acids, which are beneficial for heart health. Whole milk, fried chicken, and bacon and eggs are higher in saturated fats and cholesterol, making them less suitable choices for this client. Whole milk is high in saturated fat, while fried chicken and bacon and eggs are sources of both saturated fat and cholesterol, which can negatively impact heart health in clients with coronary artery disease.

5. A client is being taught about the use of an albuterol inhaler. Which of the following instructions should be included?

• A. Use the inhaler every 4 hours around the clock.
• B. Shake the inhaler well before use.
• C. Rinse your mouth with water after each use.
• D. Use the inhaler while lying down.

Correct answer: B

Rationale: Shaking the inhaler well before use is a crucial step in ensuring proper medication delivery. This action helps disperse the medication evenly within the device, optimizing the effectiveness of each dose. It ensures that the client receives the intended amount of medication. The other options are incorrect: Option A suggests a fixed time interval for inhaler use, which may not be suitable for all clients and can lead to overuse. Option C, rinsing the mouth, is more relevant for corticosteroid inhalers to prevent oral thrush. Option D, using the inhaler while lying down, is not recommended as it may lead to improper drug delivery and is not the correct position for inhaler use.

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