Nursing Elites

1. Why should the client diagnosed with rheumatic heart disease be advised to notify the dentist before dental procedures?

• A. The client requires prophylactic antibiotics before treatment.
• B. The client may experience dysrhythmias with high-speed drills.
• C. The client may have an adverse reaction to lidocaine with epinephrine.
• D. The client may develop heart failure during stressful events.

Correct answer: A

Rationale: Clients with rheumatic heart disease are at risk for infective endocarditis, a serious infection of the heart lining or valves. They need prophylactic antibiotics before invasive procedures, including dental work, to prevent this life-threatening complication. While dysrhythmias with high-speed drills, adverse reactions to local anesthesia, and the risk of heart failure during stressful events are all concerns for clients with heart conditions, the primary reason for notifying the dentist before dental procedures in rheumatic heart disease is the need for prophylactic antibiotics to prevent infective endocarditis.

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

• A. Weight gain
• B. Increased heart rate
• C. Heat intolerance
• D. Elevated blood pressure

Correct answer: C

Rationale: The correct answer is C: Heat intolerance. Heat intolerance is a concerning sign of levothyroxine toxicity and should be reported to the provider promptly. Levothyroxine is a medication used to treat hypothyroidism by supplementing the body's thyroid hormones. When a client experiences heat intolerance, it can indicate that the dose of levothyroxine is too high, leading to hyperthyroidism symptoms. Weight gain, increased heart rate, and elevated blood pressure are not typically associated with levothyroxine toxicity; instead, they are more commonly seen in conditions like hypothyroidism.

3. The patient with a history of myocardial infarction (MI) is prescribed aspirin. What instruction should the nurse include in the discharge teaching?

• A. Take the aspirin with food to prevent gastrointestinal upset
• B. Discontinue the aspirin if experiencing ringing in the ears
• C. Take the aspirin at bedtime to minimize side effects
• D. Avoid taking aspirin if also taking other NSAIDs

Correct answer: A

Rationale: Taking aspirin with food is recommended to prevent gastrointestinal irritation and upset, which are common side effects of aspirin. It helps protect the stomach lining and reduce the risk of developing ulcers. This instruction is crucial in promoting medication adherence and minimizing discomfort for the patient. Choices B, C, and D are incorrect because discontinuing aspirin without consulting a healthcare provider, taking it at bedtime, or avoiding it if taking other NSAIDs can have negative consequences on the patient's health and treatment plan.

4. A client with heart failure is prescribed an angiotensin-converting enzyme (ACE) inhibitor. The nurse should reinforce which instruction?

• A. Take the medication at bedtime.
• B. Report a persistent dry cough.
• C. Increase potassium-rich foods in the diet.
• D. Avoid taking the medication with meals.

Correct answer: B

Rationale: The correct answer is to instruct the client to report a persistent dry cough. ACE inhibitors can cause a common side effect of a persistent dry cough, which should be promptly reported to the healthcare provider for further evaluation and possible medication adjustment. Option A is incorrect because the timing of ACE inhibitor administration is usually not specified to be at bedtime. Option C is incorrect as increasing potassium-rich foods can lead to hyperkalemia when taking ACE inhibitors. Option D is incorrect because ACE inhibitors can be taken with or without food.

5. The nurse is caring for a client who has undergone a coronary artery bypass graft (CABG) surgery. Which action should the nurse take to prevent postoperative complications?

• A. Encourage the client to cough and deep breathe every 1 to 2 hours.
• B. Maintain the client in a supine position at all times.
• C. Keep the client on bed rest for the first 48 hours.
• D. Restrict the client's fluid intake to prevent overload.

Correct answer: A

Rationale: Encouraging the client to cough and deep breathe every 1 to 2 hours is crucial post-CABG surgery to prevent respiratory complications, such as atelectasis and pneumonia. These actions help to expand lung volume, clear secretions, and prevent the collapse of alveoli. Choices B, C, and D are incorrect because maintaining the client in a supine position at all times can lead to complications like decreased lung expansion, keeping the client on bed rest for the first 48 hours may increase the risk of thromboembolism, and restricting fluid intake postoperatively can lead to dehydration and electrolyte imbalances.

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