Nursing Elites

1. A client in labor who received epidural anesthesia experiences a sudden drop in blood pressure. What action should the nurse take first?

• A. Administer oxygen via nasal cannula.
• B. Administer an intravenous fluid bolus.
• C. Prepare the client for an emergency cesarean section.
• D. Place the client in a lateral position.

Correct answer: D

Rationale: In a client experiencing a sudden drop in blood pressure after epidural anesthesia, the first action the nurse should take is to place the client in a lateral position. This position helps improve venous return and cardiac output by relieving aortocaval compression. Administering oxygen via nasal cannula may be necessary if the client shows signs of respiratory distress, but it is not the first priority in this situation. Administering an intravenous fluid bolus can help stabilize blood pressure, but repositioning the client takes precedence. Preparing the client for an emergency cesarean section is not indicated solely based on a sudden drop in blood pressure after epidural anesthesia; this step would be considered if other complications arise.

2. What breakfast selection indicates appropriate dietary management for osteoporosis?

• A. Pancakes with syrup and orange juice
• B. Bagel with jelly and skim milk
• C. Eggs with sausage and whole milk
• D. French toast with butter and syrup

Correct answer: B

Rationale: The correct answer is B. A bagel with jelly and skim milk is a calcium-rich and low-fat option that aligns with the dietary recommendations for managing osteoporosis. Osteoporosis is a condition characterized by weak and brittle bones, so it is essential to consume an adequate amount of calcium while avoiding excess fat intake. Choices A, C, and D are not ideal for osteoporosis management as they either lack sufficient calcium, contain high fat content, or both.

3. A client with peripheral artery disease reports leg cramps while walking. What intervention should the nurse recommend?

• A. Encourage the client to rest immediately when cramping occurs.
• B. Recommend that the client increase their intake of potassium-rich foods.
• C. Advise the client to take a short break, then continue walking.
• D. Recommend that the client avoid walking altogether to prevent cramps.

Correct answer: C

Rationale: For clients with peripheral artery disease, advising the client to take a short break when leg cramps occur and then continue walking is the appropriate intervention. This approach, known as interval walking, helps manage pain from intermittent claudication and improves circulation over time. Choice A is incorrect because immediate rest may not be necessary, and encouraging the client to resume walking after a short break is more beneficial. Choice B is incorrect since increasing potassium-rich foods may not directly address the underlying issue of peripheral artery disease causing cramps. Choice D is incorrect as avoiding walking altogether can lead to further deconditioning and worsen symptoms over time.

4. The nurse is providing care for a client with severe peripheral arterial disease (PAD). The client reports a history of rest ischemia, with leg pain that occurs during the night. Which action should the nurse take in response to this finding?

• A. Elevate the legs on pillows
• B. Encourage ambulation and leg exercises
• C. Provide a heating pad for warmth
• D. Offer cold packs when the pain occurs

Correct answer: C

Rationale: Providing warmth can help dilate peripheral vessels and increase blood flow, relieving ischemic pain. In PAD, where there is already compromised blood flow, elevating the legs or applying cold therapy could worsen ischemic pain by further reducing blood flow to the extremities. Encouraging ambulation and leg exercises may be beneficial in other conditions but not suitable for clients with severe PAD experiencing rest ischemia.

5. A client is admitted with a diagnosis of schizophrenia. The client refuses to take medication and states 'I don't think I need those medications. They make me too sleepy and drowsy. I insist that you explain their use and side effects.' The nurse should understand that

• A. A referral is needed to the psychiatrist who is to provide the client with answers
• B. The client has a right to know about the prescribed medications
• C. Such education is an independent decision of the individual nurse whether or not to teach clients about their medications
• D. Clients with schizophrenia are at a higher risk of psychosocial complications when they know about their medication side effects

Correct answer: B

Rationale: The correct answer is B. The client has a legal right to be informed about their treatment, including medication uses and side effects, as part of informed consent. This helps ensure that the client can make an informed decision about their care. Choice A is incorrect because the nurse can provide the client with information about their medications. Choice C is incorrect as it is not an independent decision of the nurse but a professional responsibility to educate clients. Choice D is incorrect as knowledge about medication side effects can actually empower clients to manage their condition effectively.

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