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The nurse is caring for a client with heart failure who develops a persistent, dry cough after starting enalapril. Which of the following new prescriptions would the nurse anticipate for this client?
- A. Alprazolam
- B. Guaifenesin
- C. Lisinopril
- D. Valsartan
Correct Answer: D
Rationale: A dry cough is a common side effect of ACE inhibitors like enalapril, so switching to an ARB like valsartan (D) is anticipated. Alprazolam (A), guaifenesin (B), and lisinopril (C, another ACE inhibitor) are inappropriate.
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An 8-year old is admitted with drooling, muffled phonation and a temperature of 102.6°. The nurse should immediately notify the doctor because the child's symptoms are suggestive of:
- A. Strep throat
- B. Epiglottitis
- C. Laryngotracheobronchitis
- D. Bronchiolitis
Correct Answer: B
Rationale: Drooling, muffled phonation, and fever suggest epiglottitis, a medical emergency requiring immediate intervention due to the risk of airway obstruction.
The nurse is assisting with the care of a client who sustained a cervical spinal cord injury 1 hour ago and has paralysis in all four extremities. Which of the following actions would be a priority for the nurse to take?
- A. Reposition the client every 2 hours.
- B. Monitor the client for autonomic dysreflexia.
- C. Check the client's respiratory status frequently
- D. Perform passive range-of-motion exercises every 4 hours.
Correct Answer: C
Rationale: Respiratory status (C) is the priority in acute cervical spinal cord injury due to risk of respiratory failure. Repositioning (A), dysreflexia monitoring (B), and exercises (D) are secondary.
The nurse is caring for a client with benign prostatic hypertrophy (BPH). Which of the following assessments would the nurse anticipate finding?
- A. Large volume of urinary output with each voiding
- B. Involuntary voiding with coughing and sneezing
- C. Frequent urination
- D. Urine is dark and concentrated
Correct Answer: C
Rationale: Frequent urination. BPH causes overflow incontinence with frequent urination in small amounts due to bladder obstruction.
A client is admitted for hemodialysis. Which abnormal lab value would the nurse anticipate not being improved by hemodialysis?
- A. Low hemoglobin
- B. Hypernatremia
- C. High serum creatinine
- D. Hyperkalemia
Correct Answer: A
Rationale: Low hemoglobin. Hemodialysis corrects electrolyte imbalances but does not improve anemia.
A client who has been waiting for several hours in the clinic waiting room suddenly begins to shout, 'I need some attention and I need it now!' How should the nurse respond initially?
- A. Tell the client to be quiet and that she will be seen as soon as possible
- B. Immediately call security and the police
- C. Talk with the woman and determine her immediate needs
- D. Explain to the woman how busy the doctors are and that she will be seen soon
Correct Answer: C
Rationale: Engaging the client to assess her needs de-escalates agitation and addresses concerns. Silencing, calling security, or explaining delays may escalate tension.