Nursing Elites

1. A nurse is caring for a client who has cirrhosis and a new prescription for lactulose. The nurse should monitor the client for which of the following therapeutic effects of this medication?

• A. Improved mental status.
• B. Increased urine output.
• C. Decreased serum ammonia.
• D. Decreased bilirubin levels.

Correct answer: C

Rationale: The correct answer is C: Decreased serum ammonia. Lactulose is prescribed to decrease serum ammonia levels in clients with cirrhosis and hepatic encephalopathy. By reducing serum ammonia, lactulose helps improve the mental status of these clients. Therefore, monitoring for decreased serum ammonia is crucial to assess the effectiveness of lactulose therapy. Choice A (Improved mental status) is indirectly related as it is the desired outcome of decreasing ammonia levels. Choices B (Increased urine output) and D (Decreased bilirubin levels) are not directly associated with the therapeutic effects of lactulose in cirrhosis and hepatic encephalopathy.

2. A nurse is teaching a client who has a new prescription for captopril. Which of the following instructions should the nurse include?

• A. Take this medication with food.
• B. Take this medication 1 hour before meals.
• C. Avoid potassium supplements while taking this medication.
• D. You may experience a persistent, dry cough while taking this medication.

Correct answer: D

Rationale: The correct answer is D. Captopril is known to cause a persistent, dry cough as a common side effect. Instructing the client about this potential side effect is crucial for their awareness. Choices A and B are incorrect because captopril is usually taken on an empty stomach. Choice C is incorrect because captopril can lead to hyperkalemia, so potassium supplements may be necessary in some cases.

3. A nurse is planning to teach a group of clients about preventing low back pain. Which of the following information should the nurse include?

• A. Wear low-heeled shoes.
• B. Elevate the legs while sitting.
• C. Engage in prolonged sitting to rest the back muscles.
• D. Sleep on a soft mattress to prevent strain on the back.

Correct answer: A

Rationale: The correct answer is A: 'Wear low-heeled shoes.' Wearing low-heeled shoes helps prevent back strain by promoting proper posture. High heels can cause an imbalance in the body's alignment, leading to increased stress on the lower back. Choices B, C, and D are incorrect. Elevating the legs while sitting can help with circulation but does not directly prevent low back pain. Engaging in prolonged sitting can actually contribute to low back pain due to decreased muscle activity and increased pressure on the spine. Sleeping on a soft mattress may not provide adequate support for the back, potentially worsening back pain instead of preventing it.

4. A nurse is providing discharge instructions for a client who has osteoporosis. Which of the following instructions should the nurse include to prevent injury?

• A. Perform weight-bearing exercises.
• B. Avoid crossing the legs beyond the midline.
• C. Avoid sitting in one position for prolonged periods.
• D. Splint the affected area.

Correct answer: A

Rationale: The correct answer is A: Perform weight-bearing exercises. Weight-bearing exercises are crucial for preventing bone density loss in clients with osteoporosis. These exercises help strengthen bones and reduce the risk of fractures. Option B, avoiding crossing the legs beyond the midline, is not directly related to preventing injury in osteoporosis. Option C, avoiding sitting in one position for prolonged periods, is important for preventing pressure ulcers but does not specifically address preventing injury in osteoporosis. Option D, splinting the affected area, is not a standard recommendation for preventing injury in osteoporosis.

5. A client has a hemoglobin level of 7 g/dL. Which of the following findings should the nurse expect?

• A. Bounding pulses
• B. Elevated blood pressure
• C. Headache
• D. Pale, cool skin

Correct answer: D

Rationale: Pale, cool skin is a common finding in clients with a hemoglobin level of 7 g/dL due to decreased oxygen carrying capacity. Bounding pulses (Choice A) are not typically associated with low hemoglobin levels. Elevated blood pressure (Choice B) is not a common finding in clients with anemia. While headache (Choice C) can occur with anemia, it is not a specific finding directly related to a hemoglobin level of 7 g/dL.

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