Nursing Elites

1. The client at risk for thrombophlebitis receives reinforcement from the LPN/LVN regarding measures to minimize its occurrence. Which statement by the client indicates an understanding of this information?

• A. I should avoid sitting for prolonged periods.
• B. I will take frequent walks and avoid prolonged bed rest.
• C. I should drink plenty of fluids to stay hydrated.
• D. I will use compression stockings as advised by my doctor.

Correct answer: B

Rationale: The correct answer is B. Taking frequent walks and avoiding prolonged bed rest are essential measures to promote circulation and reduce the risk of thrombophlebitis. Physical activity helps prevent blood from pooling and clotting in the veins, thus decreasing the likelihood of thrombophlebitis development. Choice A is incorrect because while avoiding prolonged sitting is important, it is not as effective as engaging in physical activity. Choice C is not directly related to preventing thrombophlebitis. Choice D, using compression stockings, is a helpful measure but not as effective as regular physical activity in preventing thrombophlebitis.

2. A healthcare provider is providing discharge instructions to a client who has a new prescription for warfarin. Which of the following statements should the healthcare provider include?

• A. Avoid using a soft toothbrush.
• B. Report any signs of bleeding.
• C. Increase your intake of leafy green vegetables.
• D. Take the medication with food.

Correct answer: B

Rationale: The correct answer is to instruct the client to report any signs of bleeding when taking warfarin. Warfarin is an anticoagulant medication that increases the risk of bleeding, so it is essential to monitor for any signs of abnormal bleeding and report them promptly for appropriate management. Choices A, C, and D are incorrect. Instructing the client to avoid using a soft toothbrush is not directly related to warfarin therapy. Increasing the intake of leafy green vegetables is not recommended as they contain vitamin K, which can interfere with warfarin's anticoagulant effects. Taking warfarin with food can be inconsistent and may not result in optimal absorption.

3. A client with a history of coronary artery disease (CAD) is being discharged after angioplasty. Which instruction should the LPN/LVN reinforce to the client?

• A. You should report any chest pain or discomfort to your health care provider.
• B. Avoid all physical activity for the next 2 weeks.
• C. Return to work immediately after discharge.
• D. Take aspirin only if you experience chest pain.

Correct answer: A

Rationale: The correct instruction to reinforce is to 'Report any chest pain or discomfort to your health care provider.' This is crucial because chest pain post-angioplasty can indicate complications that need immediate attention. Choice A is incorrect because returning to work immediately may not be advisable after angioplasty, as the client needs time to recover. Choice B is incorrect because avoiding all physical activity for 2 weeks may not be necessary; instead, gradual resumption of activities is usually recommended. Choice D is incorrect because aspirin should be taken as prescribed by the healthcare provider, not just when chest pain occurs.

4. A client with a diagnosis of hypertension is prescribed atenolol (Tenormin). The nurse should monitor the client for which common side effect of this medication?

• A. Tachycardia
• B. Dry mouth
• C. Hypotension
• D. Increased appetite

Correct answer: C

Rationale: Corrected Rationale: Atenolol is a beta-blocker that commonly causes hypotension by lowering blood pressure. Therefore, monitoring for hypotension is crucial to prevent potential complications in the client receiving this medication. The other options are incorrect: A) Tachycardia is not a common side effect of atenolol as it typically reduces heart rate, B) Dry mouth is not a typical side effect of atenolol, and D) Increased appetite is not commonly associated with atenolol use.

5. When educating a client with a new prescription for nitroglycerin, which of the following instructions should the nurse include?

• A. Store the medication in a cool, dark place.
• B. Take the medication before bedtime.
• C. Take the medication with food.
• D. Take the medication at the first sign of chest pain.

Correct answer: D

Rationale: The correct instruction for a client with a new prescription for nitroglycerin is to take the medication at the first sign of chest pain. Nitroglycerin is a vasodilator used to relieve chest pain associated with angina. Taking it at the onset of chest pain ensures prompt relief by dilating blood vessels and increasing blood flow to the heart muscle. Storing nitroglycerin in a cool, dark place helps maintain its potency, while taking it with food can alter its absorption. Timing the medication with bedtime is not necessary, but prompt administration at the first sign of chest pain is crucial for effective management of angina. Choices A, B, and C are incorrect because storing the medication in a cool, dark place, taking it before bedtime, and taking it with food are not essential instructions for nitroglycerin use. The priority is to administer it promptly when chest pain occurs to achieve optimal therapeutic effects.

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