Nursing Elites

1. A 30-year-old male client reports difficulty sleeping due to anxiety about his upcoming surgery. What intervention would be most appropriate for the nurse to suggest?

• A. Suggest taking a mild sedative before bed.
• B. Encourage physical activity before bedtime.
• C. Advise listening to calming music before bed.
• D. Recommend reading a book before bed.

Correct answer: A

Rationale: The most appropriate intervention for the nurse to suggest to a 30-year-old male client experiencing difficulty sleeping due to anxiety about his upcoming surgery is to recommend taking a mild sedative before bed. A mild sedative can help manage anxiety and improve sleep in such situations. Encouraging physical activity before bedtime, advising to listen to calming music, or recommending reading a book may not directly address the client's anxiety and may not be as effective in promoting sleep in this scenario.

2. A client is receiving continuous intravenous heparin for a deep vein thrombosis. Which laboratory result should the nurse monitor to ensure therapeutic heparin levels?

• A. International normalized ratio (INR)
• B. Activated partial thromboplastin time (aPTT)
• C. Hemoglobin
• D. Platelet count

Correct answer: B

Rationale: The activated partial thromboplastin time (aPTT) is the most accurate measure of heparin's therapeutic effect. Heparin increases the time it takes for blood to clot, and the aPTT helps determine whether the dose is within the desired range for anticoagulation therapy. Monitoring the INR, hemoglobin, or platelet count is not specific to assessing therapeutic heparin levels and may not reflect the anticoagulant effect of heparin.

3. A male client reports that he took tadalafil 10 mg two hours ago and now feels flushed. What action should the nurse take?

• A. Instruct the client to increase oral fluid intake.
• B. Reassure the client that flushing is a common side effect.
• C. Advise the client to take nitroglycerin as a precaution.
• D. Ask the client to come to the emergency room.

Correct answer: B

Rationale: The correct answer is B: Reassure the client that flushing is a common side effect. Tadalafil, a medication used for erectile dysfunction, can cause flushing as a common side effect. In this situation, the nurse should provide reassurance to the client that the flushing is expected and not necessarily a cause for concern. Increasing oral fluid intake (choice A) may be beneficial for other conditions but is not directly related to tadalafil-induced flushing. Advising the client to take nitroglycerin (choice C) is incorrect, as nitroglycerin is not indicated for flushing. Asking the client to come to the emergency room (choice D) is unnecessary at this point since flushing is a known side effect and does not typically require urgent medical attention.

4. The nurse is conducting intake interviews of children at a city clinic. Which child is most susceptible to contracting lead poisoning?

• A. An 8-year-old living in a housing project.
• B. A 2-year-old playing on aging playground equipment.
• C. An adolescent working in a paint factory.
• D. A 10-year-old with Type 1 diabetes.

Correct answer: B

Rationale: The correct answer is B. Young children, like the 2-year-old playing on aging playground equipment, are more susceptible to lead poisoning from environmental sources due to their behaviors like hand-to-mouth contact and exploratory behaviors. Choices A, C, and D are less likely to be at high risk for lead poisoning compared to young children due to differences in exposure levels and behaviors related to potential sources of lead contamination.

5. A 48-year-old client with chronic alcoholism is admitted to the hospital. The nurse would anticipate that the client may be deficient in which vitamins?

• A. Vitamin B and vitamin C
• B. Vitamin D and vitamin E
• C. Vitamin K and vitamin A
• D. Vitamin A and vitamin E

Correct answer: A

Rationale: The correct answer is A. Chronic alcoholism commonly leads to deficiencies in B vitamins, particularly thiamine, and vitamin C. Thiamine deficiency can result in serious neurological issues like Wernicke-Korsakoff syndrome, while vitamin C deficiency can lead to scurvy. Choices B, C, and D are incorrect because vitamin D and E deficiencies are not typically associated with chronic alcoholism.

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