Nursing Elites

1. 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.

2. The client is starting therapy with digoxin (Lanoxin). What instruction should the nurse reinforce about the medication?

• A. Take the medication with meals.
• B. Avoid dairy products.
• C. Monitor for yellow or blurred vision.
• D. Increase potassium-rich foods in the diet.

Correct answer: C

Rationale: The correct answer is C: 'Monitor for yellow or blurred vision.' When a client is taking digoxin, it is crucial to monitor for signs of toxicity, such as yellow or blurred vision, as these can indicate an adverse reaction. Reporting these visual disturbances promptly to the healthcare provider is important for further evaluation and management to prevent potential complications. Choices A, B, and D are incorrect because taking digoxin with meals, avoiding dairy products, or increasing potassium-rich foods are not specific instructions related to monitoring for adverse effects of digoxin therapy.

3. The client with heart failure is receiving digoxin (Lanoxin). The nurse should monitor the client for which sign of digoxin toxicity?

• A. Hypertension
• B. Bradycardia
• C. Hyperglycemia
• D. Insomnia

Correct answer: B

Rationale: Bradycardia is a common sign of digoxin toxicity. Digoxin can cause disturbances in the heart's electrical conduction system, leading to a slower heart rate. Therefore, the nurse should closely monitor the client's heart rate for signs of bradycardia, which could indicate digoxin toxicity. Hypertension (Choice A), hyperglycemia (Choice C), and insomnia (Choice D) are not typically associated with digoxin toxicity. Therefore, they are incorrect choices for this question.

4. A client has a new prescription for alendronate. Which of the following instructions should be included in the teaching?

• A. Take the medication with a full glass of water.
• B. Lie down for 30 minutes after taking the medication.
• C. Take the medication at bedtime.
• D. Avoid dairy products while taking the medication.

Correct answer: A

Rationale: The correct instruction for taking alendronate is to take it with a full glass of water to prevent esophageal irritation. This helps ensure proper absorption and reduces the risk of irritation to the esophagus. Choice B is incorrect because patients should remain upright for at least 30 minutes after taking alendronate to prevent esophageal irritation. Choice C is incorrect as alendronate should be taken in the morning on an empty stomach. Choice D is also incorrect as there is no specific requirement to avoid dairy products while taking alendronate.

5. The client with a history of angina pectoris reports chest pain unrelieved by nitroglycerin. Which action should the nurse take next?

• A. Administer another dose of nitroglycerin.
• B. Notify the healthcare provider immediately.
• C. Have the client lie down and rest.
• D. Encourage the client to take deep breaths.

Correct answer: B

Rationale: When a client with a history of angina pectoris reports chest pain unrelieved by nitroglycerin, it may indicate a myocardial infarction, also known as a heart attack. In this situation, the nurse should immediately notify the healthcare provider to ensure prompt evaluation and appropriate intervention. Delay in seeking medical attention for chest pain unrelieved by nitroglycerin can be life-threatening, as it might be a sign of a more serious cardiac event. Administering another dose of nitroglycerin (Choice A) without further evaluation can be risky, as the client's condition may require a different intervention. Having the client lie down and rest (Choice C) or encouraging deep breaths (Choice D) are not appropriate actions in this scenario where a more serious cardiac event needs to be ruled out.

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