Nursing Elites

1. A client in the second trimester of pregnancy asks how to treat constipation. Which of the following should the nurse recommend?

• A. Decrease intake of vitamins and supplements to every other day
• B. Eat 15 g of fiber per day
• C. Consume 48 ounces of water daily
• D. Drink hot water with lemon juice each morning

Correct answer: D

Rationale: The correct answer is D: Drink hot water with lemon juice each morning. Drinking hot water with lemon juice can help stimulate bowel movements, making it a natural and safe recommendation for pregnant clients experiencing constipation. Choice A is incorrect because reducing vitamin and supplement intake may not directly address constipation. Choice B, eating 15 g of fiber per day, could be helpful but may not be as effective as the correct answer for immediate relief. Choice C, consuming 48 ounces of water daily, is essential for overall health but may not be as directly effective as the correct answer in alleviating constipation.

2. A 55-year-old client has levothyroxine ordered. Which of the below past medical history concerns may contraindicate with her medication management of hypothyroidism?

• A. Osteoporosis
• B. Scleroderma
• C. Asthma
• D. Peripheral vascular disease

Correct answer: A

Rationale: Clients with a history of osteoporosis should be carefully monitored when prescribed levothyroxine. Chronic overtreatment can cause increased bone loss, which raises the risk of fractures, especially in older adults. Thyroid hormone levels should be regularly monitored to avoid this complication. Scleroderma (choice B), asthma (choice C), and peripheral vascular disease (choice D) are not known to contraindicate the use of levothyroxine for hypothyroidism.

3. A school nurse is developing a teaching plan about testicular cancer for a group of adolescents. What information should the nurse include in the teaching?

• A. Expect pain in the testicles during self-examination.
• B. The testicles should be uniform in size and shape when examined.
• C. Expect testicles to be uniform in consistency when performing a testicular self-examination.
• D. The testicles will shrink if cancer is present.

Correct answer: C

Rationale: The correct answer is C because during a testicular self-examination, it is crucial to note a uniform consistency of the testicles. Any lumps, changes in size, or inconsistencies should be reported to a healthcare provider promptly. Choice A is incorrect because pain is not typically expected during a testicular self-examination. Choice B is incorrect as uniform size and shape are not as relevant as uniform consistency. Choice D is incorrect; testicular cancer usually causes enlargement rather than shrinking of the testicles.

4. A nurse is providing discharge instructions to a client following a below-the-knee amputation. Which of the following instructions should the nurse include?

• A. Avoid sitting in a chair for prolonged periods.
• B. Sleep with a pillow under the residual limb.
• C. Elevate the limb continuously for the first 48 hours.
• D. Apply lotion to the residual limb daily.

Correct answer: A

Rationale: The correct answer is to instruct the client to avoid sitting in a chair for prolonged periods. This is important to prevent contractures from developing in the residual limb. Sleeping with a pillow under the residual limb can contribute to contracture formation rather than prevent it. While elevation of the limb is important for reducing swelling and promoting circulation, continuous elevation for 48 hours is not necessary and may not be practical. Applying lotion to the residual limb daily is generally not recommended immediately post-amputation as the wound site needs to heal without interference from lotions or creams.

5. A nurse is caring for a client with Alzheimer's disease. Which action should the nurse include in the care plan to support the client’s cognitive function?

• A. Place a daily calendar in the kitchen
• B. Replace buttoned clothing with zippered items
• C. Replace carpet with hardwood floors
• D. Create variation in the daily routine

Correct answer: A

Rationale: Placing a daily calendar in the kitchen is beneficial for clients with Alzheimer's disease as it helps in orienting them to time and enhances cognitive function. This visual aid can assist in keeping track of days and activities. Choice B, replacing buttoned clothing with zippered items, is more related to promoting independence in dressing rather than directly supporting cognitive function. Choice C, replacing carpet with hardwood floors, focuses on safety and mobility rather than cognitive function. Choice D, creating variation in the daily routine, may be helpful for engagement and stimulation but does not directly address cognitive function as effectively as using a daily calendar.

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