The HCP ordered an angiotensin-converting enzyme (ACE) inhibitor for the client diagnosed with a myocardial infarction. Which statement best explains the rationale for administering this medication to this client?
- A. It will help prevent the development of congestive heart failure.
- B. This medication will help decrease the client's blood pressure.
- C. ACE inhibitors increase the contractility of the heart muscle.
- D. They will help decrease the development of atherosclerosis.
Correct Answer: A
Rationale: ACE inhibitors reduce afterload and prevent ventricular remodeling, lowering CHF risk post-MI, per ACC/AHA guidelines. BP, contractility, or atherosclerosis are secondary.
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When providing discharge teaching to a client with asthma, the nurse will warn against the use of which of the following over-the-counter medications?
- A. Cortisone ointments for skin rashes
- B. Aspirin products for pain relief
- C. Cough medications containing guaifenesin
- D. Histamine blockers for gastric distress
Correct Answer: B
Rationale: Aspirin products for pain relief. Aspirin is known to induce asthma attacks. Aspirin can also cause nasal polyps and rhinitis. Warn individuals with asthma about signs and symptoms resulting from complications due to aspirin ingestion.
The nurse is to administer a subcutaneous (SC) injection. Which technique is correct?
- A. Pull the skin taut. Insert a 21-gauge needle at a 90-degree angle.
- B. Pinch the skin. Insert a 25-gauge needle at a 45-degree angle.
- C. Stretch the skin taut. Insert a 27-gauge needle at a 10-degree angle.
- D. Pinch the skin. Insert a 21-gauge needle at a 60-degree angle.
Correct Answer: B
Rationale: The skin should be pinched, and a 25-gauge needle should be inserted at a 45-degree angle. Answer 1 describes an IM injection. Answer 3 describes an intradermal injection.
An 80 year-old client is admitted with a diagnosis of malnutrition. In addition to physical assessments, which of the following lab tests should be closely monitored?
- A. Urine protein
- B. Urine creatinine
- C. Serum calcium
- D. Serum albumin
Correct Answer: D
Rationale: Serum albumin. Serum albumin is a valuable indicator of protein deficiency and, later, nutritional status in adults. A normal reading for an elder's serum albumin is between 3.0-5.0 g/dl.
The nurse is teaching a group of women in a community clinic about prevention of osteoporosis. Which of the following over-the-counter medications should the nurse recognize as having the most elemental calcium per tablet?
- A. Calcium chloride
- B. Calcium citrate
- C. Calcium gluconate
- D. Calcium carbonate
Correct Answer: D
Rationale: Calcium carbonate. Calcium carbonate contains 400 mg of elemental calcium in 1 gram of calcium carbonate.
The 38-year-old client with chronic asthma is prescribed a leukotriene receptor antagonist. Which is the scientific rationale for administering this medication?
- A. This medication is used prophylactically to control asthma.
- B. This medication will cure the client's chronic asthma.
- C. It will stabilize mast cell activities and reduce asthma attacks.
- D. It will cause the bronchioles to dilate and increase the airway.
Correct Answer: A
Rationale: Leukotriene receptor antagonists (e.g., montelukast) are prophylactic, reducing inflammation to control asthma. They don’t cure, stabilize mast cells, or directly dilate bronchioles.
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