Nursing Elites

1. A client reports recent exposure to hepatitis A. What is a common mode of transmission for this virus?

• A. Blood transfusion
• B. Fecal-oral route
• C. Needle sharing
• D. Sexual contact

Correct answer: B

Rationale: Hepatitis A is commonly transmitted through the fecal-oral route, often via ingestion of contaminated food or water. This mode of transmission is why proper hygiene, sanitation, and vaccination are essential in preventing the spread of hepatitis A.

2. What is the primary action of digoxin when prescribed to a patient with heart failure?

• A. Increase heart rate
• B. Decrease cardiac output
• C. Strengthen cardiac contractions
• D. Lower blood pressure

Correct answer: C

Rationale: Digoxin, when prescribed to a patient with heart failure, primarily acts by strengthening cardiac contractions. This leads to an improvement in cardiac output, making it an essential medication in managing heart failure. By enhancing the force of contractions, digoxin helps the heart pump more effectively and efficiently, leading to better circulation and symptom control in patients with compromised cardiac function.

3. The nurse is planning care for a client with cirrhosis of the liver. Which intervention should the nurse include to reduce the risk of bleeding?

• A. Monitor for signs of infection.
• B. Limit the client's dietary protein intake.
• C. Administer vitamin K as prescribed.
• D. Encourage the client to increase fluid intake.

Correct answer: C

Rationale: Administering vitamin K as prescribed can help reduce the risk of bleeding in clients with cirrhosis by promoting clotting factor production. Cirrhosis often leads to impaired liver function, affecting the synthesis of clotting factors. Vitamin K supplementation helps in the production of these essential clotting factors, thus reducing the risk of bleeding in clients with cirrhosis. Monitoring for signs of infection (Choice A) is important for overall care but not directly related to reducing the risk of bleeding in cirrhosis. Limiting dietary protein intake (Choice B) may be necessary in some cases of cirrhosis but does not directly address the risk of bleeding. Encouraging increased fluid intake (Choice D) is beneficial for various aspects of health but does not specifically target the risk of bleeding in cirrhosis.

4. A client with a history of atrial fibrillation is prescribed dabigatran (Pradaxa). Which instruction should the nurse include in the client's teaching?

• A. Take the medication with food to improve absorption.
• B. Avoid foods high in vitamin K.
• C. Take the medication at the same time each day.
• D. Increase your intake of high-potassium foods.

Correct answer: C

Rationale: The correct instruction for the nurse to include in the client's teaching regarding dabigatran (Pradaxa) is to take the medication at the same time each day. This ensures a consistent blood level and effectiveness of the medication, which is crucial in managing atrial fibrillation and preventing complications. It helps maintain a steady therapeutic effect and reduces the risk of erratic drug levels in the body.

5. In planning the turning schedule for a bedfast client, it is most important for the nurse to consider what assessment finding?

• A. 4+ pitting edema of both lower extremities.
• B. A Braden risk assessment scale rating score of ten.
• C. Warm, dry skin with a fever of 100° F.
• D. Hypoactive bowel sounds with infrequent bowel movements.

Correct answer: B

Rationale: A low Braden score indicates a high risk for pressure ulcers, making regular turning crucial to prevent skin breakdown.

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