Nursing Elites

1. The nurse is caring for a client with hypertension who is prescribed 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: The correct answer is B: Hypotension. Enalapril is an ACE inhibitor that works by dilating blood vessels and reducing blood pressure. Therefore, a potential adverse effect of enalapril is hypotension, not hypertension (choice A), tachycardia (choice C), or hyperglycemia (choice D). Monitoring for hypotension is crucial to prevent complications.

2. A healthcare professional is assessing a client who has been taking levodopa/carbidopa for Parkinson's disease. Which of the following findings should the healthcare professional report to the provider?

• A. Dry mouth
• B. Urinary retention
• C. Bradykinesia
• D. Dizziness

Correct answer: C

Rationale: Bradykinesia is a cardinal symptom of Parkinson's disease characterized by slowness of movement. An increase in bradykinesia may indicate a decline in the client's condition and the need for adjustments in their medication regimen. Therefore, the healthcare professional should promptly report this finding to the provider for further evaluation and management. Choices A, B, and D are not directly related to the client's Parkinson's disease or the medication levodopa/carbidopa. Dry mouth is a common side effect of many medications, including anticholinergics, but not specifically levodopa/carbidopa. Urinary retention and dizziness are also not typically associated with levodopa/carbidopa use for Parkinson's disease.

3. The healthcare provider is preparing to assist in the care of a client who has just returned from coronary artery bypass graft (CABG) surgery. Which is the priority action?

• A. Monitor the client's urine output.
• B. Check the client's surgical dressing.
• C. Measure the client's blood pressure.
• D. Assess the client's level of consciousness.

Correct answer: D

Rationale: Assessing the client's level of consciousness is the priority action post-CABG surgery to monitor for signs of cerebral hypoxia or other complications that require immediate intervention. Changes in the client's level of consciousness can indicate neurological deterioration, which is critical to address promptly in this postoperative period. Monitoring urine output, checking surgical dressing, and measuring blood pressure are important aspects of postoperative care but assessing the client's level of consciousness takes precedence as it provides crucial information about the client's neurological status and the need for urgent intervention.

4. 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.

5. The client has been prescribed atorvastatin (Lipitor) for hyperlipidemia. Which instruction should the nurse provide to the client?

• A. Take the medication in the morning with breakfast.
• B. Avoid drinking grapefruit juice while taking this medication.
• C. Increase your intake of dietary fiber while on this medication.
• D. Avoid eating foods high in potassium.

Correct answer: B

Rationale: The correct instruction for the nurse to provide to the client prescribed atorvastatin (Lipitor) for hyperlipidemia is to avoid drinking grapefruit juice while taking this medication. Grapefruit juice can interfere with the metabolism of atorvastatin, leading to an increased risk of side effects. It is crucial for the client to adhere to this instruction to ensure the effectiveness and safety of the treatment. Choices A, C, and D are incorrect because taking the medication with breakfast, increasing dietary fiber intake, and avoiding foods high in potassium are not specific instructions related to atorvastatin therapy for hyperlipidemia.

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