Nursing Elites

1. A nurse is assessing a newborn who is 1-day old and receiving phototherapy for jaundice. Which action should the nurse take?

• A. Feed the infant glucose water every 2 hours.
• B. Ensure the newborn wears a diaper.
• C. Keep the infant's head covered with a cap.
• D. Apply lotion to the newborn every 4 hours.

Correct answer: C

Rationale: The correct action for the nurse to take is to keep the infant's head covered with a cap. This helps regulate the newborn's body temperature during phototherapy. Option A, feeding the infant glucose water every 2 hours, is incorrect because it is not a standard intervention for newborns receiving phototherapy. Option B, ensuring the newborn wears a diaper, may be necessary for hygiene but is not directly related to phototherapy. Option D, applying lotion to the newborn every 4 hours, is unnecessary and not indicated for managing jaundice or phototherapy.

2. A client with type 1 diabetes mellitus is receiving foot care education from a nurse. Which of the following instructions should the nurse include?

• A. Soak your feet in warm water daily.
• B. Wear cotton socks.
• C. Apply lotion to your feet after bathing.
• D. Trim toenails straight across.

Correct answer: D

Rationale: The correct answer is D: 'Trim toenails straight across.' In clients with diabetes, trimming toenails straight across is important to prevent ingrown toenails, reducing the risk of infections. Soaking feet in warm water daily (choice A) can lead to dry skin and potentially cause skin breakdown in diabetic clients. While wearing cotton socks (choice B) is beneficial for good foot hygiene, it is not as crucial as trimming toenails correctly. Applying lotion to feet after bathing (choice C) is helpful for moisturizing the skin, but the emphasis should be on nail care to prevent complications like ingrown toenails.

3. A nurse in a mental health unit is planning room assignments for four clients. Which of the following clients should be closest to the nurse's station?

• A. A client who has an anxiety disorder and is experiencing moderate anxiety.
• B. A client who has somatic symptom disorder and reports chronic pain.
• C. A client who has depressive disorder and reports feeling hopeless.
• D. A client who has bipolar disorder and impaired social interactions.

Correct answer: D

Rationale: A client with bipolar disorder and impaired social interactions should be placed closest to the nurse's station for closer monitoring. Clients with bipolar disorder may experience mood swings, including manic episodes that can lead to impulsive behaviors or aggression. Placing such a client near the nurse's station allows for quick intervention and monitoring of their social interactions, especially if they are impaired. The other options, such as anxiety disorder, somatic symptom disorder, and depressive disorder, do not inherently require immediate proximity to the nurse's station based on the information provided.

4. A nurse is caring for a client with schizophrenia. Which of the following assessment findings should the nurse expect?

• A. Decreased level of consciousness
• B. Inability to identify common objects
• C. Poor problem-solving ability
• D. Preoccupation with somatic disturbances

Correct answer: B

Rationale: In schizophrenia, clients often display an inability to identify common objects due to cognitive impairment. This is known as associative agnosia, where individuals struggle to recognize familiar objects, faces, or sounds. Choices A, C, and D are not typically associated with schizophrenia. Decreased level of consciousness is more indicative of conditions like head trauma or drug overdose. Poor problem-solving ability may be seen in various mental health disorders but is not specific to schizophrenia. Preoccupation with somatic disturbances is more commonly seen in somatic symptom disorders or somatic delusions, not a typical finding in schizophrenia.

5. A nurse is providing teaching to a client who has mild persistent asthma and has been prescribed montelukast. Which of the following statements should the nurse include in the teaching?

• A. This medication can be used to help you during an acute asthma attack.
• B. This medication helps decrease swelling and mucus production.
• C. This medication should be taken before exercise.
• D. This medication should be taken daily in the evening.

Correct answer: D

Rationale: The correct answer is D. Montelukast should be taken daily in the evening for long-term control of asthma, rather than for immediate relief. Choice A is incorrect because montelukast is not used for acute asthma attacks. Choice B is incorrect as montelukast works by blocking leukotrienes, not by decreasing swelling and mucus production. Choice C is incorrect as montelukast is not specifically taken before exercise.

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