Nursing Elites

1. 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.

2. 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.

3. The healthcare provider has reinforced dietary instructions to a client with coronary artery disease. Which statement by the client indicates an understanding of the dietary instructions?

• A. I should substitute eggs and milk for meat.
• B. I will eliminate all cholesterol and fat from my diet.
• C. I should routinely use polyunsaturated oils in my diet.
• D. I need to consider becoming a strict vegetarian.

Correct answer: C

Rationale: The correct answer is C. Using polyunsaturated oils, such as vegetable oils, can help manage cholesterol levels and reduce the risk of heart disease. This dietary change is beneficial for individuals with coronary artery disease as it promotes heart health by improving cholesterol profiles. Substituting eggs and milk for meat (Choice A) may not address the overall dietary needs for managing the condition. Completely eliminating all cholesterol and fat from the diet (Choice B) is not necessary as the body needs some healthy fats. Considering becoming a strict vegetarian (Choice D) is a personal choice and may not necessarily be required to manage coronary artery disease.

4. The healthcare provider is monitoring a client with chronic stable angina. Which symptom would indicate that the client's condition is worsening?

• A. Increased shortness of breath with exertion
• B. Improved tolerance to activity
• C. Decreased frequency of chest pain
• D. Stable blood pressure readings

Correct answer: A

Rationale: Increased shortness of breath with exertion is a concerning symptom in a client with chronic stable angina as it may indicate inadequate oxygen supply to the heart muscle, suggesting a worsening condition. This could be a sign of reduced blood flow to the heart, leading to increased work for the heart during exertion, resulting in increased shortness of breath. Choice B, improved tolerance to activity, is incorrect as it would indicate a positive response to treatment. Choice C, decreased frequency of chest pain, is incorrect as it would also suggest an improvement in the client's condition. Choice D, stable blood pressure readings, are not indicative of a worsening condition in chronic stable angina.

5. A client has a new prescription for prednisone. Which of the following statements should the nurse include in the teaching?

• A. You may experience weight gain.
• B. Increase your intake of vitamin K.
• C. Expect increased urinary output.
• D. You may have dark, tarry stools.

Correct answer: A

Rationale: The correct answer is A: 'You may experience weight gain.' Prednisone commonly causes weight gain as a side effect, so it is important for the client to be aware of this potential outcome. Monitoring weight changes can be essential in managing the medication's effects and overall health. Choices B, C, and D are incorrect. Increasing vitamin K intake is not specifically related to prednisone use. Expecting increased urinary output is not a common side effect of prednisone. Dark, tarry stools are more commonly associated with gastrointestinal bleeding rather than prednisone use.

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