Nursing Elites

1. The client with Raynaud's phenomenon is being taught by the nurse about preventing episodes. Which instruction should the nurse reinforce?

• A. Wear gloves in cold weather.
• B. Avoid caffeine and chocolate.
• C. Increase intake of vitamin C.
• D. Use a heating pad for warmth.

Correct answer: A

Rationale: The correct answer is A: 'Wear gloves in cold weather.' Wearing gloves in cold weather is essential for preventing vasoconstriction and subsequent episodes of Raynaud's phenomenon. Cold temperatures can trigger vasospasms in individuals with Raynaud's, and wearing gloves helps maintain warmth and prevent the constriction of blood vessels in the extremities, reducing the likelihood of an episode. Choices B, C, and D are incorrect because while avoiding caffeine and chocolate, increasing vitamin C intake, and using a heating pad for warmth can be beneficial for overall health, they are not specifically targeted at preventing Raynaud's phenomenon episodes triggered by cold weather.

2. A client has a new prescription for captopril. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Monitor for signs of hypokalemia.
• C. Take the medication at bedtime.
• D. Monitor for a dry cough.

Correct answer: D

Rationale: The correct answer is to monitor for a dry cough. Captopril is known to cause a persistent dry cough as a common side effect. If a dry cough develops, it should be reported to the healthcare provider promptly, as it may necessitate discontinuation of the medication. Choice A is incorrect because captopril is usually taken on an empty stomach. Choice B is incorrect as hypokalemia is not a common side effect of captopril. Choice C is incorrect as captopril is typically taken during the day and not specifically at bedtime.

3. The nurse is planning measures to decrease the incidence of chest pain for a client with angina pectoris. What intervention should the nurse do to effectively accomplish this goal?

• A. Provide a quiet and low-stimulus environment.
• B. Encourage the family to visit very frequently.
• C. Encourage the client to call friends and relatives each day.
• D. Recommend that the client watch TV as a constant diversion.

Correct answer: A

Rationale: The correct answer is A: Provide a quiet and low-stimulus environment. A calm and quiet environment can help reduce stress, which is beneficial in preventing the occurrence of chest pain in clients with angina. Choice B is incorrect because excessive or frequent visitations may lead to increased stress and agitation for the client. Choice C is incorrect as it may not always contribute to a calm environment and could potentially increase the client's stress levels. Choice D is inappropriate as watching TV constantly may not promote a quiet and low-stimulus environment, which is essential in managing angina pectoris.

4. A client has a new prescription for sertraline. Which of the following statements by the client indicates an understanding of the teaching?

• A. I should take this medication at bedtime.
• B. I may experience sexual dysfunction.
• C. I should avoid drinking grapefruit juice.
• D. I may experience weight loss while taking this medication.

Correct answer: B

Rationale: The correct answer is B. Sexual dysfunction is a common side effect of sertraline. When the client mentions this potential side effect, it indicates an understanding of the teaching about the medication's effects. This response shows awareness of a significant adverse effect that the client should be informed about when starting sertraline. Choices A, C, and D are incorrect because taking sertraline at bedtime, avoiding grapefruit juice, or experiencing weight loss are not key teaching points associated with this medication.

5. A client with a diagnosis of angina pectoris is prescribed nitroglycerin tablets. How should the nurse instruct the client to take the medication?

• A. Swallow the tablet whole with water
• B. Place the tablet under the tongue and let it dissolve
• C. Chew the tablet and then swallow
• D. Place the tablet between the cheek and gum

Correct answer: B

Rationale: Nitroglycerin is most effective when administered sublingually (under the tongue) as it is rapidly absorbed into the bloodstream. Placing the tablet under the tongue allows for quick absorption and faster relief of angina symptoms. Chewing the tablet, swallowing it, or placing it between the cheek and gum would not provide the same rapid onset of action needed during an angina episode. Therefore, the correct instruction for the client is to place the nitroglycerin tablet under the tongue and let it dissolve for optimal effectiveness.

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