Nursing Elites

1. The client with heart failure is prescribed furosemide (Lasix). Which electrolyte imbalance is the nurse most likely to monitor for?

• A. Hyperkalemia
• B. Hypernatremia
• C. Hypokalemia
• D. Hyponatremia

Correct answer: C

Rationale: The correct answer is C: Hypokalemia. Furosemide, a loop diuretic, commonly causes potassium loss, leading to hypokalemia. The nurse should closely monitor for decreased potassium levels in a client receiving furosemide to prevent complications such as cardiac arrhythmias or muscle weakness. Hyperkalemia (Choice A) is not typically associated with furosemide use. Hypernatremia (Choice B) refers to high sodium levels and is not the primary concern with furosemide. Hyponatremia (Choice D) is low sodium levels, which can occur but is less common than hypokalemia in clients taking furosemide.

2. The nurse is teaching a client with coronary artery disease (CAD) about the risk factors for the disease. Which modifiable risk factor should the nurse emphasize?

• A. Family history
• B. Age
• C. Cigarette smoking
• D. Gender

Correct answer: C

Rationale: Cigarette smoking is a modifiable risk factor for coronary artery disease (CAD) as it can be changed or controlled to reduce the risk of developing CAD. Family history, age, and gender are non-modifiable risk factors that cannot be changed. Emphasizing the importance of quitting smoking can help the client reduce their risk of CAD and improve their overall cardiovascular health. Therefore, the correct answer is C. Choice A (Family history), B (Age), and D (Gender) are non-modifiable risk factors and not the focus of modifiable risk reduction strategies in CAD prevention.

3. The nurse is teaching a client about lifestyle changes to manage hypertension. Which dietary change should the nurse recommend?

• A. Increase intake of red meat
• B. Use salt substitutes liberally
• C. Limit sodium intake to 2 grams per day
• D. Increase intake of processed foods

Correct answer: C

Rationale: The correct answer is C: 'Limit sodium intake to 2 grams per day.' This recommendation is crucial in managing hypertension because excessive sodium intake can lead to elevated blood pressure. Reducing sodium intake helps the body regulate fluid balance and lower blood pressure. Choices A, B, and D are incorrect. Increasing red meat intake can worsen hypertension due to its high saturated fat content. Using salt substitutes liberally can also be harmful as they often contain high amounts of potassium, which can be problematic for individuals with certain health conditions. Increasing processed foods consumption is generally discouraged in hypertension management due to their high sodium content and low nutritional value.

4. A client with chronic obstructive pulmonary disease (COPD) is prescribed theophylline. Which adverse effect should the nurse monitor for that indicates toxicity?

• A. Tachycardia
• B. Constipation
• C. Drowsiness
• D. Tremors

Correct answer: A

Rationale: The correct answer is A: Tachycardia. Tachycardia is a common sign of theophylline toxicity. The nurse should monitor the client for an increased heart rate, as it can indicate a dangerous level of theophylline in the body. Prompt medical attention is required if tachycardia is observed to prevent further complications. Choices B, C, and D are incorrect because constipation, drowsiness, and tremors are not typically associated with theophylline toxicity. While theophylline can cause gastrointestinal upset or central nervous system effects, tachycardia is a more specific and serious indicator of toxicity that requires immediate attention.

5. The healthcare provider is monitoring a client with left-sided heart failure. Which assessment finding indicates that the client's condition is worsening?

• A. Clear lung sounds
• B. Increased peripheral pulses
• C. Bibasilar crackles
• D. Improved activity tolerance

Correct answer: C

Rationale: Bibasilar crackles are abnormal lung sounds that indicate fluid accumulation in the lungs, a sign that left-sided heart failure is worsening. This finding suggests that the client's condition is deteriorating and requires prompt intervention to prevent further complications. Clear lung sounds (Choice A) are normal and would not indicate worsening heart failure. Increased peripheral pulses (Choice B) may be seen in conditions like anxiety or exercise, but not specifically in worsening left-sided heart failure. Improved activity tolerance (Choice D) would be a positive sign, not an indicator of worsening heart failure.

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