Nursing Elites

1. A client is scheduled for a colonoscopy. Which of these instructions should the nurse provide?

• A. You should avoid eating or drinking anything after midnight the day before the test.
• B. You may have a light breakfast the morning of the test.
• C. You will need to drink a bowel preparation solution the day before the test.
• D. You will need to avoid taking any medications the day before the test.

Correct answer: C

Rationale: The correct answer is C: 'You will need to drink a bowel preparation solution the day before the test.' Before a colonoscopy, it is essential to cleanse the colon thoroughly by drinking a bowel preparation solution. This helps to ensure that the colon is clear for the procedure, allowing for better visualization and examination of the colon. Choices A, B, and D are incorrect because avoiding eating or drinking after midnight, having a light breakfast, and avoiding medications are not specific instructions related to the colonoscopy preparation process.

2. A nurse is collecting data from a client who has diabetes and is overweight. The client tells the nurse that she wants to start an exercise program. Which of the following actions should the nurse take first?

• A. Determine the client's usual pattern of activity.
• B. Assist the client in developing a healthy eating plan.
• C. Encourage the client to join a support group.
• D. Provide the client with a list of signs and symptoms to report to the provider.

Correct answer: A

Rationale: Assessing the client's usual pattern of activity is crucial as it helps the nurse understand the client's current level of physical activity, any limitations, and areas needing improvement. This information is essential to create a safe and effective exercise plan tailored to the client's specific needs. Choice B, assisting the client in developing a healthy eating plan, is important but not the first step when the client's immediate goal is to start an exercise program. Encouraging the client to join a support group may be beneficial for motivation and emotional support but is not the priority at this stage. Providing a list of signs and symptoms to report to the provider is important for client education but is not the initial step when the client expresses a desire to begin an exercise program.

3. The client is being taught about precautions with Coumadin therapy. Which over-the-counter medication should the client be instructed to avoid?

• A. Non-steroidal anti-inflammatory drugs
• B. Cough medicines with guaifenesin
• C. Histamine blockers
• D. Laxatives containing magnesium salts

Correct answer: A

Rationale: The correct answer is A: Non-steroidal anti-inflammatory drugs (NSAIDs). When a client is on Coumadin therapy, NSAIDs should be avoided because they can increase the risk of bleeding due to their antiplatelet effects. Choices B, C, and D are incorrect. Cough medicines with guaifenesin, histamine blockers, and laxatives containing magnesium salts do not have a significant interaction with Coumadin therapy that would necessitate avoidance.

4. A client has been diagnosed with Zollinger-Ellison syndrome. Which information is most important for the nurse to reinforce with the client?

• A. It is a condition in which one or more tumors, called gastrinomas, form in the pancreas or in the upper part of the small intestine (duodenum).
• B. It is critical to promptly report any findings of peptic ulcers to your health care provider.
• C. Treatment consists of medications to reduce acid and heal any peptic ulcers and, if possible, surgery to remove any tumors.
• D. The average age at diagnosis is 50 years, and peptic ulcers may occur in unusual areas of the stomach or intestine.

Correct answer: B

Rationale: Prompt reporting of peptic ulcers is crucial in managing Zollinger-Ellison syndrome to prevent complications and guide treatment. While choices A, C, and D provide relevant information about the condition and its treatment, the most important aspect in the client's care is the prompt reporting of peptic ulcers. This is because untreated peptic ulcers in Zollinger-Ellison syndrome can lead to serious complications such as gastrointestinal bleeding or perforation. Therefore, ensuring timely communication with the healthcare provider is essential for effective management of the condition.

5. A nurse checks a client who is on a volume-cycled ventilator. Which finding indicates that the client may need suctioning?

• A. drowsiness
• B. complaint of nausea
• C. pulse rate of 92
• D. restlessness

Correct answer: D

Rationale: Restlessness is often a sign of respiratory distress or secretion build-up, indicating the need for suctioning. While drowsiness (choice A) can be a sign of hypoxia, it is not as immediate an indication for suctioning as restlessness. Complaint of nausea (choice B) and a pulse rate of 92 (choice C) are not directly related to the need for suctioning in a client on a volume-cycled ventilator.

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