Nursing Elites

1. A client who has been receiving chemotherapy for cancer has a platelet count of 20,000/mm3. Which intervention should the nurse include in the plan of care?

• A. Apply ice packs to bruised areas.
• B. Encourage frequent oral hygiene.
• C. Avoid invasive procedures.
• D. Place the client in a private room.

Correct answer: C

Rationale: The correct intervention for a client with a platelet count of 20,000/mm3 due to chemotherapy is to avoid invasive procedures. Chemotherapy can cause a decrease in platelet count, leading to an increased risk of bleeding. By avoiding invasive procedures, the nurse helps reduce the risk of bleeding complications. Applying ice packs to bruised areas (Choice A) may further increase the risk of bleeding due to the pressure and potential trauma to the skin. Encouraging frequent oral hygiene (Choice B) is important for overall health but does not directly address the risk of bleeding associated with a low platelet count. Placing the client in a private room (Choice D) is not directly related to managing the platelet count and risk of bleeding; it is more about privacy and infection control, which are important but not the priority in this scenario.

2. A community health nurse is planning a program to address the rising rates of obesity in the community. Which intervention should the nurse prioritize?

• A. organizing community exercise programs
• B. distributing educational materials on healthy eating
• C. partnering with local grocery stores to provide discounts on healthy foods
• D. conducting health screenings for early detection of obesity-related conditions

Correct answer: A

Rationale: The correct answer is A: organizing community exercise programs. Physical activity plays a crucial role in weight management and reducing obesity rates. While educating about healthy eating (choice B) is important, focusing on exercise programs can have a more direct impact on addressing obesity. Partnering with local grocery stores for discounts on healthy foods (choice C) is beneficial but may not address the root cause of obesity. Conducting health screenings (choice D) is more reactive than proactive in addressing rising obesity rates.

3. The healthcare professional is planning a health education workshop for a group of adolescents on the dangers of substance abuse. Which strategy is most likely to be effective?

• A. showing videos of the effects of substance abuse
• B. inviting individuals in recovery to share their stories
• C. providing statistical data on substance abuse
• D. distributing brochures on substance abuse prevention

Correct answer: B

Rationale: Inviting individuals in recovery to share their stories is the most effective strategy for educating adolescents about the dangers of substance abuse. Personal stories have a significant impact as they provide real-life examples of the consequences of substance abuse, making the information more relatable and emotionally engaging. This approach can evoke empathy, create a deeper understanding of the risks involved, and potentially deter adolescents from experimenting with substances. Showing videos of the effects of substance abuse (choice A) may be impactful, but personal narratives often have a stronger emotional connection. Providing statistical data (choice C) may not resonate as strongly with adolescents as personal stories. Distributing brochures (choice D) is informative but may not have the same emotional impact and engagement as hearing firsthand experiences.

4. A female client with a history of chronic obstructive pulmonary disease (COPD) is being treated at home and is currently receiving oxygen at 2 liters via nasal cannula. The spouse, who is the caregiver, reports that the client requires assistance when ambulating short distances, including going to the bathroom. Which suggestion should the health care nurse provide to the caregiver?

• A. disconnect oxygen when ambulating to the bathroom
• B. administer a breathing treatment prior to ambulation
• C. suggest obtaining a bedside commode for toileting
• D. ask for additional assistance to reduce the risk of falls

Correct answer: C

Rationale: For a client with COPD requiring assistance for short-distance ambulation, suggesting a bedside commode for toileting is the most appropriate intervention. This recommendation helps reduce the need for the client to walk long distances, thereby minimizing the risk of exertion and potential falls. Disconnecting oxygen during ambulation (Choice A) is not safe for a client with COPD, as oxygen therapy should be continuous. Administering a breathing treatment before ambulation (Choice B) may not directly address the client's need for assistance with toileting. Asking for additional assistance (Choice D) can be beneficial but providing a bedside commode specifically addresses the current issue of ambulating short distances for toileting.

5. The healthcare provider is preparing to administer atropine, an anticholinergic, to a client scheduled for a cholecystectomy. The client asks the provider to explain the reason for the prescribed medication. What response is best for the provider to provide?

• A. To increase gastric motility.
• B. To decrease the risk of bradycardia during surgery.
• C. To reduce secretions.
• D. To prevent nausea and vomiting.

Correct answer: B

Rationale: Atropine, an anticholinergic medication, is used preoperatively to prevent bradycardia by increasing the automaticity of the sinoatrial node during surgical anesthesia. Choice A is incorrect because atropine does not affect gastric motility. Choice C is incorrect as atropine is not primarily used to reduce secretions. Choice D is also incorrect because preventing nausea and vomiting is not the primary purpose of administering atropine in this context.

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