Nursing Elites

1. The client with myocardial infarction should reduce intake of saturated fat and cholesterol. Which food items from the dietary menu would assist the nurse in helping the client comply with diet therapy?

• A. Cheeseburger, pan-fried potatoes, whole kernel corn, sherbet
• B. Pork chop, baked potato, cauliflower in cheese sauce, ice cream
• C. Baked haddock, steamed broccoli, herbed rice, sliced strawberries
• D. Spaghetti and sweet sausage in tomato sauce, vanilla pudding (with 4% milk)

Correct answer: C

Rationale: Option C, which includes baked haddock, steamed broccoli, herbed rice, and sliced strawberries, is the most appropriate choice for a client with myocardial infarction looking to reduce saturated fat and cholesterol intake. This meal is low in saturated fats and cholesterol, making it a heart-healthy option that aligns with the dietary recommendations for such clients. Choices A, B, and D contain foods high in saturated fats and cholesterol, which are not suitable for a client with myocardial infarction trying to adhere to a diet therapy aimed at reducing these components.

2. A client has a new prescription for amitriptyline. Which of the following instructions should the nurse include?

• A. Take the medication in the morning.
• B. Avoid consuming grapefruit juice.
• C. Take the medication with a full glass of water.
• D. Monitor for signs of weight gain.

Correct answer: C

Rationale: When a client is prescribed amitriptyline, it is important to instruct them to take the medication with a full glass of water. This instruction helps prevent esophageal irritation, as amitriptyline can be harsh on the esophagus. Option C is the correct choice. Option A, taking the medication in the morning, is not specific to amitriptyline and can vary depending on the individual's condition. Option B, avoiding grapefruit juice, is a general precaution for many medications but not specifically related to amitriptyline. Option D, monitoring for signs of weight gain, is not a direct instruction for taking the medication itself and may not be a common side effect of amitriptyline.

3. A client with a history of heart failure is being discharged with a prescription for digoxin (Lanoxin). The nurse should include which instruction in the discharge teaching?

• A. Take your pulse before each dose and hold the medication if your pulse is below 60 beats per minute.
• B. Increase your fluid intake to at least 3 liters per day.
• C. Report any weight loss of more than 2 pounds in a week.
• D. Take the medication with meals to avoid gastrointestinal upset.

Correct answer: A

Rationale: The correct instruction for discharge teaching regarding digoxin (Lanoxin) is to advise the client to take their pulse before each dose and to hold the medication if their pulse is below 60 beats per minute. Digoxin can cause bradycardia, so monitoring the pulse is crucial to prevent potential complications. Choice B is incorrect because excessive fluid intake can lead to fluid overload, worsening heart failure. Choice C is not directly related to digoxin therapy. Choice D is inaccurate as digoxin is usually taken on an empty stomach to facilitate absorption.

4. The healthcare provider assesses a client who has been prescribed furosemide (Lasix) for cardiac disease. Which electrocardiographic change would be a concern for a client taking a diuretic?

• A. Tall, spiked T waves
• B. A prolonged QT interval
• C. A widening QRS complex
• D. Presence of a U wave

Correct answer: D

Rationale: The presence of a U wave is often associated with hypokalemia, a possible side effect of diuretic therapy like furosemide. Hypokalemia can lead to U wave formation on an electrocardiogram, making the presence of U waves a concerning finding in clients taking diuretics. Tall, spiked T waves are typically seen in hyperkalemia, not hypokalemia. A prolonged QT interval is more commonly associated with conditions like Long QT syndrome or certain medications, not specifically with diuretics. A widening QRS complex is usually seen in conditions affecting the conduction system of the heart, such as bundle branch blocks, rather than being directly related to diuretic use.

5. While assessing a client taking propranolol, which finding should the nurse report to the provider?

• A. Bradycardia
• B. Dry mouth
• C. Constipation
• D. Increased appetite

Correct answer: A

Rationale: Bradycardia is a significant side effect of propranolol, a beta-blocker that slows the heart rate. It indicates potential cardiovascular complications and should be reported promptly to the healthcare provider for further evaluation and management. Dry mouth, constipation, and increased appetite are common side effects of various medications but are not directly associated with propranolol's mechanism of action.

Similar Questions