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A patient with chronic heart failure is prescribed carvedilol. What is the primary purpose of this medication?
- A. Increase cardiac output
- B. Reduce fluid retention
- C. Decrease heart rate
- D. Lower blood pressure
Correct Answer: C
Rationale: The correct answer is C: Decrease heart rate. Carvedilol is a beta-blocker that works by blocking the beta-adrenergic receptors in the heart, leading to a decrease in heart rate. This helps reduce the workload of the heart and improve its efficiency in patients with heart failure. Choice A is incorrect because carvedilol may not necessarily increase cardiac output directly. Choice B is incorrect because carvedilol focuses more on improving heart function rather than directly reducing fluid retention. Choice D is incorrect because while carvedilol may lower blood pressure as a secondary effect, its primary purpose in heart failure is to improve cardiac function by decreasing heart rate.
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While assessing a 70-year-old female client with Alzheimer's disease, the nurse notes deep inflamed cracks at the corners of her mouth. What intervention should the nurse include in this client's plan of care?
- A. Apply a moisturizing cream to the affected areas.
- B. Encourage the client to consume foods rich in vitamin B.
- C. Notify the healthcare provider for further evaluation.
- D. Ensure that the client gets adequate B vitamins in foods or supplements.
Correct Answer: D
Rationale: The correct answer is D because deep inflamed cracks at the corners of the mouth can be a sign of vitamin B deficiency, specifically B2 (riboflavin) or B3 (niacin). Ensuring the client gets adequate B vitamins through foods or supplements can help address the deficiency and improve the condition. Option A is incorrect as simply applying a moisturizing cream does not address the underlying cause. Option B is not the best choice because while vitamin B-rich foods are beneficial, they may not be sufficient to correct a deficiency. Option C is not the immediate priority unless there are other concerning symptoms present.
When covering another nurse's assignment during a lunch break, based on the status report provided, which client should the charge nurse check first?
- A. The client admitted yesterday with diabetic ketoacidosis whose blood glucose level is now 195 mg/dl.
- B. The client with an ileal conduit created two days ago with a scant amount of blood in the drainage pouch.
- C. The client post-triple coronary bypass four days ago who has serosanguinous drainage in the chest tube.
- D. The client with a pneumothorax secondary to a gunshot wound with a current pulse oximeter reading of 90%.
Correct Answer: D
Rationale: The correct answer is D because a pneumothorax with a pulse oximeter reading of 90% indicates potential respiratory compromise, requiring immediate attention to prevent further deterioration. A pneumothorax can lead to decreased oxygenation, which is critical for the client's health and needs prompt intervention. Checking this client first is essential to ensure timely management and prevent any adverse outcomes.
Choice A is incorrect because a blood glucose level of 195 mg/dl in a client with diabetic ketoacidosis, while elevated, does not pose an immediate threat to life compared to respiratory compromise.
Choice B is incorrect as a scant amount of blood in the drainage pouch does not indicate an urgent situation or immediate risk to the client's health.
Choice C is incorrect as serosanguinous drainage in a chest tube post-triple coronary bypass, while requiring monitoring, does not indicate an immediate need for intervention compared to a potential respiratory compromise in choice D.
A patient with type 2 diabetes is prescribed metformin. What instruction should the nurse provide regarding this medication?
- A. Take the medication on an empty stomach.
- B. Monitor for signs of hypoglycemia.
- C. Take the medication with meals.
- D. Increase intake of simple carbohydrates.
Correct Answer: C
Rationale: Step-by-step rationale for choice C:
1. Metformin can cause gastrointestinal side effects.
2. Taking it with meals helps reduce stomach upset.
3. It also helps in better absorption and effectiveness.
4. Therefore, the nurse should instruct the patient to take metformin with meals.
Summary of other choices:
A: Taking on an empty stomach can worsen gastrointestinal side effects.
B: Metformin doesn't typically cause hypoglycemia.
D: Increasing simple carbohydrates can counteract the effects of metformin.
A young adult female client is seen in the emergency department for a minor injury following a motor vehicle collision. She states she is very angry at the person who hit her car. What is the best nursing response?
- A. You are lucky to be alive. Be grateful no one was killed.'
- B. I understand your car was not seriously damaged.'
- C. You are upset that this incident has brought you here.'
- D. Have you ever been in the emergency department before?'
Correct Answer: C
Rationale: The correct answer is C: "You are upset that this incident has brought you here." This response acknowledges the client's feelings of anger and validates her emotions, showing empathy and understanding. It demonstrates active listening and therapeutic communication, which is crucial in building trust and rapport with the client.
Choice A is incorrect as it dismisses the client's feelings of anger and invalidates her emotions by shifting the focus to being grateful instead. Choice B is incorrect as it minimizes the client's emotional response by focusing on the material aspect of the situation rather than addressing her feelings. Choice D is incorrect as it does not address the client's emotional state and is a closed-ended question that does not encourage further discussion or exploration of the client's feelings.
A patient with peptic ulcer disease is prescribed omeprazole. When should the patient take this medication for optimal effectiveness?
- A. With meals
- B. At bedtime
- C. Before meals
- D. After meals
Correct Answer: C
Rationale: The correct answer is C: Before meals. Omeprazole is a proton pump inhibitor that works best when taken before meals to inhibit acid secretion before food intake. Taking it with meals (choice A) may decrease its effectiveness as it needs time to be absorbed. Taking it at bedtime (choice B) may not provide optimal coverage throughout the day. Taking it after meals (choice D) may not allow enough time for the medication to start working before the next meal.