Nursing Elites

1. What is the most common cause of coronary artery disease?

• A. Atherosclerosis.
• B. Hyperlipidemia.
• C. Diabetes.
• D. Smoking.

Correct answer: A

Rationale: The correct answer is Atherosclerosis. It is the primary cause of coronary artery disease, as it involves the buildup of plaque in the arteries, restricting blood flow to the heart. Hyperlipidemia (choice B) contributes to atherosclerosis by increasing cholesterol levels in the blood but is not the direct cause of coronary artery disease. Diabetes (choice C) can accelerate atherosclerosis due to high blood sugar levels, but it is not the most common cause. Smoking (choice D) is a significant risk factor for developing coronary artery disease but is not the primary cause.

2. A 20-year-old female client calls the nurse to report a lump she found in her breast. Which response is the best for the nurse to provide?

• A. Check it again in one month, and if it is still there schedule an appointment.
• B. Most lumps are benign, but it is always best to come in for an examination.
• C. Try not to worry too much about it, because usually, most lumps are benign.
• D. If you are in your menstrual period it is not a good time to check for lumps.

Correct answer: B

Rationale: The nurse advising the client to come in provides the best response because it addresses the client's anxiety most effectively and encourages prompt and immediate action for a potential problem.

3. A client admitted with left-sided heart failure has a heart rate of 110 beats per minute and is becoming increasingly dyspneic. Which additional assessment finding by the nurse supports the client's admitting diagnosis?

• A. An enlarged, distended abdomen.
• B. Crackles in the bases of both lungs.
• C. Jugular vein distension.
• D. Peripheral edema.

Correct answer: B

Rationale: The correct answer is B. Crackles in the bases of the lungs are indicative of fluid accumulation, which is common in left-sided heart failure. In left-sided heart failure, the heart is unable to effectively pump blood from the lungs to the rest of the body, leading to a backup of fluid in the lungs. This results in crackles heard on auscultation. Choices A, C, and D are not specific to left-sided heart failure. An enlarged, distended abdomen may indicate ascites or liver congestion. Jugular vein distension is more commonly associated with right-sided heart failure, and peripheral edema is a sign of fluid accumulation in the tissues, which can occur in both types of heart failure but is not as specific to left-sided heart failure as crackles in the lungs.

4. The patient is being educated on taking hydrochlorothiazide. Which statement by the patient indicates a need for further teaching?

• A. I may need additional sodium and calcium while taking this medication.
• B. I should consume plenty of fruits and vegetables while taking this drug.
• C. I should be cautious when getting up from a bed or chair while on this medication.
• D. I will take the medication in the morning to reduce certain side effects.

Correct answer: A

Rationale: The correct answer is A because patients do not require extra sodium or calcium while taking hydrochlorothiazide, a thiazide diuretic. This medication actually promotes the excretion of sodium and water. Choices B, C, and D are correct statements regarding the use of hydrochlorothiazide. Patients are encouraged to have a diet rich in fruits and vegetables, be careful with position changes due to potential orthostatic hypotension, and take the medication in the morning to reduce the need for frequent urination during nighttime.

5. A client was admitted for a myocardial infarction and cardiogenic shock 2 days ago. Which laboratory test result should a nurse expect to find?

• A. Blood urea nitrogen (BUN) of 52 mg/dL
• B. Creatinine of 2.3 mg/dL
• C. BUN of 10 mg/dL
• D. BUN/creatinine ratio of 8:1

Correct answer: A

Rationale: In cardiogenic shock, decreased renal perfusion leads to an elevated BUN. Choice A is correct. Creatinine remains normal in cardiogenic shock as it signifies kidney damage, which has not occurred in this case. A low BUN indicates overhydration, malnutrition, or liver damage, which are not typically seen in cardiogenic shock. A low BUN/creatinine ratio is associated with fluid volume excess or acute renal tubular acidosis, not specifically indicative of cardiogenic shock.

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