Nursing Elites

1. The healthcare professional is collecting data on a client who was just admitted to the hospital with a diagnosis of coronary artery disease (CAD). The client reveals having been under a great deal of stress recently. What should the healthcare professional do next?

• A. Ask whether the client wants to seek counseling or therapy.
• B. Explore with the client the sources of stress in their life.
• C. Reassure the client that stress is common in today's world.
• D. Ask the client to make a list of stressors for later evaluation.

Correct answer: B

Rationale: It is important for the healthcare professional to explore the sources of stress with the client to develop an effective stress management plan tailored to the individual's specific stressors. By understanding the sources of stress, healthcare professionals can identify triggers, implement appropriate interventions, and support the client's overall well-being. Option A is not the immediate next step as exploring the sources of stress should come before suggesting counseling or therapy. Option C is dismissive of the client's feelings and does not address the need for personalized stress management. Option D delays the process by asking the client to make a list without actively engaging in a discussion to identify stressors.

2. A client with a new prescription for simvastatin is receiving teaching from a healthcare provider. Which of the following statements by the client indicates an understanding of the teaching?

• A. 'I should take this medication in the evening.'
• B. 'I should avoid drinking grapefruit juice.'
• C. 'I should expect my urine to be red-orange while taking this medication.'
• D. 'I will need to take this medication for the rest of my life.'

Correct answer: A

Rationale: The correct answer is A. Taking simvastatin in the evening is recommended because cholesterol synthesis increases at night. This timing maximizes the effectiveness of the medication in lowering cholesterol levels. Choice B is incorrect because grapefruit juice should be avoided with certain statins, but simvastatin is not significantly affected by grapefruit juice. Choice C is incorrect as red-orange urine is not an expected side effect of simvastatin. Choice D is incorrect because simvastatin is typically prescribed for managing cholesterol levels and may not need to be taken for the rest of the client's life.

3. The client is receiving digoxin (Lanoxin) for heart failure. Which symptom would indicate digoxin toxicity?

• A. Increased appetite
• B. Yellow or blurred vision
• C. Increased urination
• D. Diarrhea

Correct answer: B

Rationale: Yellow or blurred vision can be a sign of digoxin toxicity. These visual disturbances are concerning as they indicate a potential adverse reaction to the medication. Recognizing this symptom promptly is crucial to prevent serious complications. Increased appetite, increased urination, and diarrhea are not typically associated with digoxin toxicity. Therefore, option B is the correct choice in this scenario.

4. 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.

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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