Nursing Elites

1. The client is receiving enalapril (Vasotec). The nurse should monitor the client for which potential adverse effect?

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

Correct answer: B

Rationale: Enalapril is an ACE inhibitor that works by dilating blood vessels and reducing blood pressure. Therefore, monitoring for hypotension is crucial as it can be a potential adverse effect of this medication. Hypertension, tachycardia, and hyperglycemia are not typically associated with enalapril use. Hypertension is the condition enalapril is used to treat, so it would not be an adverse effect. Tachycardia is not a common adverse effect of enalapril. Enalapril does not typically cause hyperglycemia, as it primarily affects blood pressure regulation.

2. The healthcare provider is reviewing the medication orders for a client with angina pectoris. Which medication is typically prescribed to prevent angina attacks?

• A. Aspirin
• B. Nitroglycerin
• C. Atenolol
• D. Simvastatin

Correct answer: B

Rationale: Nitroglycerin is the medication typically prescribed to prevent angina attacks. It works by dilating blood vessels, increasing blood flow, and reducing the heart's workload, hence relieving angina symptoms. Aspirin is often used to prevent blood clots, not specifically to prevent angina attacks. Atenolol is a beta-blocker used to manage high blood pressure and chest pain but is not typically prescribed to prevent angina attacks. Simvastatin is a statin medication primarily used to lower cholesterol levels and is not indicated for preventing angina attacks.

3. The nurse is caring for a client with hypertension who is prescribed a thiazide diuretic. The nurse should check which parameter before administering the medication?

• A. Serum potassium level
• B. Blood pressure
• C. Heart rate
• D. Serum sodium level

Correct answer: B

Rationale: Before administering a thiazide diuretic to a client with hypertension, the nurse should check the blood pressure. Thiazide diuretics are prescribed to lower blood pressure, so assessing the client's blood pressure prior to administration helps to monitor the effectiveness of the medication and to ensure the client's safety. Checking the serum potassium level (Choice A), heart rate (Choice C), or serum sodium level (Choice D) are also important parameters in the care of a client on a thiazide diuretic, but the priority assessment before administering the medication is the blood pressure to evaluate the drug's effectiveness in managing hypertension.

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

• A. Store the medication in a cool, dry place.
• B. Take the medication as directed by the healthcare provider.
• C. Take the medication 30 minutes before meals.
• D. Take the medication at the first sign of chest pain.

Correct answer: D

Rationale: Instructing the client to take nitroglycerin at the first sign of chest pain is crucial for immediate relief of angina symptoms. Nitroglycerin is a fast-acting medication that helps dilate blood vessels, improving blood flow to the heart muscle. Therefore, prompt administration at the onset of chest pain is essential to alleviate anginal episodes effectively. Choices A, B, and C are incorrect because storing the medication properly, taking it as directed, or before meals are not specific instructions for managing acute anginal episodes, which require immediate action for symptom relief.

5. A client with known coronary artery disease (CAD) begins to experience chest pain while getting out of bed. What action should the nurse take?

• A. Obtain a prescription for pain medication.
• B. Have the client stop and lie back down in bed.
• C. Report the complaint to the healthcare provider.
• D. Instruct the client to continue getting out of bed and into a chair.

Correct answer: B

Rationale: When a client with CAD experiences chest pain, it indicates myocardial ischemia. The nurse should have the client stop the activity and lie back down in bed to reduce the heart's oxygen demand, decrease myocardial workload, and prevent further ischemia. This action helps in improving blood flow to the heart and can potentially alleviate the chest pain. Option A is incorrect as pain medication should not be the initial action for chest pain in CAD. Option C is incorrect because the nurse should first intervene directly to address the chest pain. Option D is incorrect as continuing the activity can worsen the myocardial ischemia and chest pain.

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