Nursing Elites

1. Which of the following is a key symptom of myocardial infarction (MI)?

• A. Chest pain.
• B. Shortness of breath.
• C. Nausea.
• D. Fatigue.

Correct answer: A

Rationale: The correct answer is A: Chest pain. Chest pain is a hallmark symptom of myocardial infarction (MI) due to inadequate blood flow to the heart muscle. This pain can be severe, crushing, or squeezing, and may radiate to the left arm, jaw, or back. Shortness of breath (choice B), nausea (choice C), and fatigue (choice D) can accompany MI but are not as specific or characteristic as chest pain in diagnosing this condition. Therefore, chest pain is the primary symptom to recognize for suspected MI.

2. A client with gouty arthritis reports tenderness and swelling of the right ankle and great toe. The nurse observes the area of inflammation extends above the ankle. The client receives prescriptions for colchicine and indomethacin. Which instruction should the nurse include in the discharge teaching?

• A. Eat high-protein foods to achieve ideal body weight
• B. Drink at least 8 cups (1920mL) of water per day
• C. Use an electric heating pad when pain is at its worst
• D. Encourage active range of motion to prevent stiffness

Correct answer: B

Rationale: The correct answer is to instruct the client to drink at least 8 cups (1920mL) of water per day. Adequate hydration helps to prevent the formation of uric acid crystals, which can exacerbate gout symptoms. Choice A is incorrect because while maintaining a healthy weight is important, it doesn't directly address gout management. Choice C is incorrect because using an electric heating pad can worsen inflammation. Choice D is incorrect because active range of motion may exacerbate pain and inflammation in the affected joints.

3. A client with type 1 diabetes mellitus who jogs daily is being taught by a nurse about the preferred sites for insulin absorption. What is the most appropriate site for this client?

• A. Arms
• B. Legs
• C. Abdomen
• D. Iliac crest

Correct answer: C

Rationale: The abdomen is the most appropriate site for insulin absorption in a client who jogs. When a client is involved in physical activity like jogging, the abdomen is preferred as it provides more consistent absorption compared to the arms or legs, which can have altered absorption rates due to increased blood flow during exercise. The iliac crest is not a common site for insulin injections and may not provide optimal absorption rates compared to the abdomen.

4. Which of the following is a priority intervention for a patient with heart failure?

• A. Administering diuretics.
• B. Administering oxygen.
• C. Administering beta-blockers.
• D. Administering vasodilators.

Correct answer: B

Rationale: Administering oxygen is a priority intervention in heart failure because it helps improve oxygenation, alleviate hypoxemia, and reduce the workload on the heart. Oxygen therapy is crucial in managing acute heart failure exacerbations. While diuretics (Choice A) are commonly used in heart failure to reduce fluid overload, administering oxygen takes precedence due to its immediate impact on oxygen delivery. Beta-blockers (Choice C) and vasodilators (Choice D) are also important in heart failure management, but in the acute setting, ensuring adequate oxygen supply is the priority.

5. The client has been receiving peritoneal dialysis. The nurse should assess the client for which of the following complications that is most likely to occur?

• A. Electrolyte imbalance
• B. Peritonitis
• C. Infection
• D. Hyperglycemia

Correct answer: B

Rationale: Peritonitis is the most likely complication to occur in clients receiving peritoneal dialysis due to the risk of infection. Peritonitis is a serious inflammation of the peritoneum lining the abdominal cavity, commonly caused by infection. While electrolyte imbalance and hyperglycemia are possible complications in some cases, peritonitis poses a more immediate and severe threat to the client's health. Infection is a general term that can encompass peritonitis but is not as specific as directly identifying peritonitis as the primary concern in this scenario.

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