Nursing Elites

1. A client with amyotrophic lateral sclerosis (ALS) is admitted to the hospital. Which intervention should the nurse include in the plan of care?

• A. Administer muscle relaxants as prescribed.
• B. Assist the client with activities of daily living (ADLs).
• C. Provide nutritional support to prevent aspiration.
• D. Encourage the client to participate in physical therapy.

Correct answer: C

Rationale: The correct intervention for a client with ALS is to provide nutritional support to prevent aspiration. ALS causes muscle weakness, including the muscles used for swallowing, increasing the risk of aspiration. Providing proper nutrition and support can help prevent this complication. Administering muscle relaxants (Choice A) may not be suitable for ALS as it can further weaken muscles. While assisting with ADLs (Choice B) and encouraging physical therapy (Choice D) are important aspects of care, the priority for a client with ALS is to prevent complications related to swallowing and nutrition.

2. What long-term risks should the nurse discuss with a patient starting on hormone replacement therapy (HRT)?

• A. HRT is associated with increased risks of cardiovascular events and breast cancer, so these risks should be discussed with the patient.
• B. HRT can improve mood and energy levels, but it also increases the risk of osteoporosis.
• C. HRT can increase the risk of venous thromboembolism, so patients should undergo regular screening.
• D. HRT decreases the risk of fractures, but it also increases the risk of developing diabetes.

Correct answer: A

Rationale: The correct answer is A. When starting on hormone replacement therapy (HRT), the nurse should discuss the increased risks of cardiovascular events and breast cancer with the patient. These risks are important to consider to make an informed decision. Choice B is incorrect as HRT does not increase the risk of osteoporosis; in fact, it may help prevent it. Choice C is incorrect as while HRT can increase the risk of venous thromboembolism, regular screening is not the primary focus for discussion. Choice D is incorrect as HRT does not decrease the risk of fractures and is not primarily associated with an increased risk of developing diabetes.

3. While in an induced coma for 3 weeks, a badly burned firefighter awakens and thanks his son for singing Happy Birthday to him a week earlier. Which part of the brain is responsible for allowing him to hear and comprehend while comatose?

• A. Cerebellum
• B. Thalamus
• C. Temporal lobe
• D. Occipital lobe

Correct answer: C

Rationale: The temporal lobe is responsible for processing auditory information, allowing the patient to hear and comprehend while in a coma. The cerebellum is primarily associated with coordination and balance, not auditory processing. The thalamus serves as a relay station for sensory information but is not specifically responsible for auditory processing. The occipital lobe is mainly involved in processing visual information, not auditory functions.

4. In which of the following cases is dehydration more likely to occur?

• A. A 50-year-old woman who is a bodybuilder
• B. A 50-year-old man who is morbidly obese
• C. A 10-year-old child who is thin
• D. A 30-year-old with multiple sclerosis

Correct answer: B

Rationale: Dehydration is more likely to occur in a 50-year-old man who is morbidly obese due to the increased risk of conditions like diabetes and heart disease that can lead to fluid imbalances. Being morbidly obese can also strain the body's systems, increasing the need for water. The other choices are less likely to experience dehydration as a primary concern. While being a bodybuilder may require strict hydration practices, dehydration is more prevalent in individuals with conditions like obesity.

5. A patient is prescribed levothyroxine (Synthroid) for hypothyroidism. What is a key point the nurse should include in the patient education?

• A. Take the medication on an empty stomach with a full glass of water to ensure proper absorption.
• B. Do not take this medication with calcium supplements.
• C. Avoid taking this medication with grapefruit juice.
• D. Take the medication with food to enhance absorption.

Correct answer: A

Rationale: The correct answer is A. Levothyroxine should be taken on an empty stomach with a full glass of water, typically 30 minutes to an hour before breakfast, to ensure proper absorption. Taking it with food, calcium supplements, or grapefruit juice can interfere with its absorption. Choice B is incorrect because taking levothyroxine with calcium supplements can reduce its effectiveness. Choice C is incorrect because grapefruit juice can also interfere with levothyroxine absorption. Choice D is incorrect because taking levothyroxine with food can decrease its absorption.

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