Nursing Elites

1. A client with a diagnosis of chronic kidney disease (CKD) is receiving epoetin alfa (Epogen). What is the primary goal of this medication?

• A. To reduce the risk of bleeding.
• B. To lower blood pressure.
• C. To stimulate red blood cell production.
• D. To increase appetite.

Correct answer: C

Rationale: The correct answer is C: 'To stimulate red blood cell production.' Epoetin alfa, such as Epogen, is used to treat anemia by stimulating red blood cell production in clients with chronic kidney disease. This medication helps increase hemoglobin levels and reduce the need for blood transfusions. Option A, 'To reduce the risk of bleeding,' is incorrect as epoetin alfa does not directly impact bleeding risk. Option B, 'To lower blood pressure,' is incorrect as epoetin alfa is not indicated for blood pressure management. Option D, 'To increase appetite,' is also incorrect as the primary goal of epoetin alfa is related to improving anemia by boosting red blood cell production.

2. A client with a diagnosis of tuberculosis (TB) is being discharged home. Which instruction is most important for the nurse to provide?

• A. Avoid close contact with others until treatment is complete.
• B. Take all prescribed medications as directed.
• C. Schedule a follow-up appointment with the healthcare provider.
• D. Wear a mask when in public places.

Correct answer: B

Rationale: The most important instruction for a client with tuberculosis (TB) is to take all prescribed medications as directed. This is crucial to prevent the development of drug-resistant TB. While avoiding close contact with others until treatment is complete (Choice A) is important to prevent the spread of TB, ensuring the client completes the prescribed medication regimen is the priority. Scheduling a follow-up appointment (Choice C) is important for monitoring but not as critical as medication adherence. Wearing a mask in public places (Choice D) can help reduce the spread of TB but is not as essential as taking medications as prescribed.

3. The nurse is caring for a client postoperatively following a thyroidectomy. Which assessment finding should be reported to the healthcare provider immediately?

• A. Hoarseness of the voice.
• B. Slight swelling at the incision site.
• C. Tingling around the mouth.
• D. Mild fever.

Correct answer: C

Rationale: Tingling around the mouth should be reported to the healthcare provider immediately as it may indicate hypocalcemia, a potential complication after thyroidectomy. Hoarseness of the voice is common postoperatively due to surgical manipulation, slight swelling at the incision site is a normal response, and a mild fever can be expected after surgery. However, tingling around the mouth suggests a potential calcium imbalance, which requires prompt attention to prevent serious complications.

4. When using a metered-dose inhaler (MDI), which step is most important for ensuring effective medication delivery?

• A. Exhale completely before using the inhaler
• B. Inhale quickly while pressing down on the inhaler
• C. Shake the inhaler for 10 seconds before use
• D. Hold breath for 5 seconds after inhaling

Correct answer: A

Rationale: The correct step to ensure effective medication delivery when using a metered-dose inhaler (MDI) is to exhale completely before using the inhaler. This action helps create more space in the lungs for the medication to reach deeply into the airways. Inhaling quickly while pressing down on the inhaler (Choice B) may cause the medication to impact the throat rather than reaching the lungs. Shaking the inhaler for 10 seconds before use (Choice C) is important to mix the medication but not the most crucial step for effective delivery. While holding the breath for 5 seconds after inhaling (Choice D) can help the medication stay in the lungs momentarily, exhaling completely before inhalation is more critical for optimal drug deposition.

5. The nurse is providing discharge instructions to a client with a diagnosis of peptic ulcer disease (PUD). Which dietary recommendation is most appropriate?

• A. Increase fiber intake.
• B. Avoid spicy foods.
• C. Avoid dairy products.
• D. Consume a high-fat diet.

Correct answer: B

Rationale: The most appropriate dietary recommendation for a client with peptic ulcer disease (PUD) is to avoid spicy foods. Spicy foods can irritate the stomach lining and exacerbate symptoms of PUD. Increasing fiber intake may be beneficial for other gastrointestinal conditions but is not the primary concern for PUD. Avoiding dairy products is not a general recommendation for PUD unless the individual has a specific intolerance. Consuming a high-fat diet can increase the risk of exacerbating PUD symptoms due to the delayed gastric emptying associated with high-fat meals.

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