Nursing Elites

1. A client who has been prescribed oral contraception receives education from a nurse. Which of the following client statements indicates a need for further education?

• A. If I miss one pill, I'll take it as soon as possible
• B. If I miss two pills, I'll double up for two days
• C. If I miss three pills, I'll double up each day until back on schedule
• D. I'll use an alternative form of contraception if I miss more than two pills

Correct answer: C

Rationale: The correct course of action after missing oral contraceptive pills depends on how many pills are missed. If three pills are missed, the client should not 'double up' but rather follow the manufacturer's instructions and use an alternative form of contraception until the next cycle. Taking too many pills at once increases the risk of side effects without restoring contraceptive protection. Choices A, B, and D demonstrate understanding of the correct actions to take after missing a pill or two, emphasizing the importance of not doubling up but following specific guidelines to maintain effectiveness and safety.

2. A client with mild persistent asthma is being taught about montelukast by a nurse. Which statement by the client indicates understanding?

• A. I will use this for asthma attacks.
• B. I should take this before exercise.
• C. This medication will decrease swelling and mucus production.
• D. I can stop this medication after 10 days.

Correct answer: C

Rationale: The correct answer is C: 'This medication will decrease swelling and mucus production.' Montelukast is a leukotriene receptor antagonist that works by reducing swelling and mucus production in the airways, helping to manage asthma symptoms in the long term. Choices A, B, and D are incorrect because montelukast is not used for immediate relief during asthma attacks, pre-exercise prophylaxis, or short-term treatment; instead, it is taken regularly for asthma control.

3. A nurse is providing dietary teaching for a client who has chronic cholecystitis. Which of the following diets should the nurse recommend?

• A. Low potassium diet
• B. High fiber diet
• C. Low fat diet
• D. Low sodium diet

Correct answer: C

Rationale: The correct answer is C: 'Low fat diet.' A client with chronic cholecystitis should follow a low-fat diet to decrease the frequency of biliary colic episodes. Fats can trigger the release of cholecystokinin, which stimulates the gallbladder to contract, potentially causing pain in individuals with cholecystitis. Choices A, B, and D are incorrect. A low potassium diet is prescribed for individuals with specific kidney conditions or on certain medications. A high fiber diet is beneficial for conditions like constipation, diverticulosis, or to promote general bowel health. A low sodium diet is often recommended for conditions like hypertension or heart failure to reduce fluid retention.

4. A client is being taught about the use of levothyroxine. Which of the following should be included?

• A. It should be taken on an empty stomach
• B. Monitor for signs of hyperthyroidism
• C. It is a pain reliever
• D. It should be taken in the morning

Correct answer: B

Rationale: When educating a client about levothyroxine, it is important to emphasize the need to monitor for signs of hyperthyroidism. Levothyroxine should be taken on an empty stomach, preferably in the morning, to maximize its absorption. Choice A is incorrect as it should not be taken with food. Choice C is incorrect as levothyroxine is not a pain reliever. Choice D is incorrect as levothyroxine is usually taken in the morning.

5. A nurse is caring for an older adult who has a nonpalpable skin lesion that is less than 0.5 cm (0.2 in) in diameter. Which of the following terms should the nurse use to document this finding?

• A. Papule
• B. Vesicle
• C. Macule
• D. Nodule

Correct answer: C

Rationale: The correct term the nurse should use to document this finding is 'Macule.' A macule is a flat, nonpalpable skin lesion that is smaller than 1 cm in diameter. In this case, the lesion described is less than 0.5 cm, making it appropriate to classify it as a macule. 'Papule' (Choice A) refers to a solid, elevated skin lesion, 'Vesicle' (Choice B) is a small fluid-filled blister, and 'Nodule' (Choice D) is a solid, elevated skin lesion that is larger and deeper than a papule, none of which accurately describe the lesion in question.

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