Nursing Elites

1. What is the preferred treatment for a patient with unstable angina admitted with chest pain?

• A. Administer sublingual nitroglycerin
• B. Establish IV access
• C. Auscultate heart sounds
• D. Obtain cardiac enzymes

Correct answer: A

Rationale: The correct answer is to administer sublingual nitroglycerin. Nitroglycerin helps vasodilate coronary arteries, improving blood flow to the heart, relieving chest pain, and preventing cardiac tissue damage. Establishing IV access (choice B) is important but not the preferred initial treatment for unstable angina with chest pain. Auscultating heart sounds (choice C) and obtaining cardiac enzymes (choice D) are relevant assessments but do not address the immediate symptomatic relief needed for a patient with unstable angina and chest pain.

2. A nurse is teaching a client about using a continuous positive airway pressure (CPAP) device to treat obstructive sleep apnea. Which of the following information should the nurse include in the teaching?

• A. It delivers a preset amount of inspiratory pressure throughout the breathing cycle
• B. It has a continuous adjustment feature that changes the airway pressure throughout the cycle
• C. It delivers a preset amount of airway pressure throughout the breathing cycle
• D. It delivers positive pressure at the end of each breath

Correct answer: C

Rationale: The correct answer is C because a CPAP device delivers a preset amount of positive airway pressure continuously throughout all inspiration and expiration cycles. Choice A is incorrect because CPAP does not deliver inspiratory pressure at the beginning of each breath; it provides continuous positive pressure. Choice B is incorrect because CPAP typically delivers a constant pressure rather than having a feature that changes pressure throughout the cycle. Choice D is incorrect as CPAP does not deliver positive pressure specifically at the end of each breath; it maintains a consistent pressure throughout the breathing cycle.

3. What lab value should be prioritized for a patient with HIV?

• A. CD4 T-cell count below 180 cells/mm3
• B. Serum albumin levels
• C. White blood cell count
• D. Hemoglobin levels

Correct answer: A

Rationale: A CD4 T-cell count below 180 cells/mm3 should be prioritized for a patient with HIV. This value is crucial as it indicates severe immunocompromise in HIV-infected individuals. Monitoring CD4 T-cell count helps assess the status of the immune system and guides treatment decisions. Serum albumin levels (choice B) may reflect the patient's nutritional status and overall health but are not as specific to HIV disease progression. White blood cell count (choice C) and hemoglobin levels (choice D) can be affected by various factors and are not as directly linked to HIV management as the CD4 T-cell count in this context.

4. What are the dietary recommendations for a patient with GERD?

• A. Avoid mint and spicy foods
• B. Eat large meals before bedtime
• C. Consume liquids with meals
• D. Avoid NSAIDs

Correct answer: A

Rationale: The correct answer is to avoid mint and spicy foods for a patient with GERD. These foods can increase gastric acid secretion and worsen symptoms of GERD. Choice B is incorrect because eating large meals before bedtime can exacerbate GERD symptoms due to increased gastric pressure when lying down. Choice C is also incorrect as consuming liquids with meals can lead to increased gastric distention, potentially triggering GERD symptoms. Choice D, avoiding NSAIDs, though important for some patients with GERD due to their potential to irritate the stomach lining, is not a general dietary recommendation for all GERD patients.

5. What are the dietary instructions for a patient with pre-dialysis end-stage kidney disease?

• A. Increase protein intake
• B. Reduce sodium intake
• C. Reduce potassium intake
• D. Restrict protein intake to 0.55-0.60 g/kg/day

Correct answer: D

Rationale: The correct answer is to restrict protein intake to 0.55-0.60 g/kg/day for a patient with pre-dialysis end-stage kidney disease. Excessive protein intake can worsen kidney function in such patients. Increasing protein intake, as mentioned in choice A, is not recommended due to the strain it puts on the kidneys. While reducing sodium intake, as in choice B, is relevant for managing blood pressure, it is not specifically related to pre-dialysis end-stage kidney disease. Choice C, reducing potassium intake, is important for patients with kidney disease, but it is not the primary dietary instruction for those with pre-dialysis end-stage kidney disease.

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