Nursing Elites

1. A client with rheumatoid arthritis is experiencing morning stiffness. Which of the following actions should the nurse take?

• A. Encourage the client to avoid physical activity in the morning.
• B. Encourage the client to take NSAIDs before bedtime.
• C. Apply cold packs to the affected joints in the morning.
• D. Perform passive range-of-motion exercises before getting out of bed.

Correct answer: C

Rationale: The correct action the nurse should take is to apply cold packs to the affected joints in the morning. Rheumatoid arthritis is characterized by inflammation, and applying cold packs can help reduce inflammation and stiffness in the joints. Encouraging the client to avoid physical activity in the morning (Choice A) may worsen stiffness, as movement is beneficial for joint mobility. While NSAIDs (Choice B) can help with pain and inflammation, applying cold packs directly to the affected joints is more targeted and effective. Performing passive range-of-motion exercises (Choice D) can be helpful, but applying cold packs is the priority for reducing inflammation and stiffness.

2. A nurse is caring for a client who has a prescription for spironolactone. Which of the following laboratory values should the nurse monitor?

• A. Sodium 140 mEq/L
• B. Calcium 9.5 mg/dL
• C. Potassium 5.2 mEq/L
• D. Magnesium 2.0 mEq/L

Correct answer: C

Rationale: The correct answer is C: Potassium 5.2 mEq/L. A potassium level of 5.2 mEq/L is elevated and should be monitored in clients taking spironolactone, which is a potassium-sparing medication. Monitoring potassium levels is crucial as spironolactone can cause hyperkalemia. Choices A, B, and D are incorrect because sodium, calcium, and magnesium levels are not typically affected by spironolactone. Therefore, the nurse should primarily focus on monitoring the potassium levels in this scenario.

3. A nurse is providing teaching to a client who has a new diagnosis of hypertension. Which of the following dietary recommendations should the nurse include?

• A. Limit sodium intake to 4 grams per day.
• B. Limit protein intake to 80 grams per day.
• C. Limit saturated fat intake to 7% of daily calories.
• D. Limit fluid intake to 1,500 mL per day.

Correct answer: C

Rationale: The correct answer is to limit saturated fat intake to 7% of daily calories. This recommendation is crucial for clients with hypertension to lower cholesterol levels and promote heart health. Choice A, limiting sodium intake to 4 grams per day, is important for hypertension but not the best recommendation compared to limiting saturated fats. Choice B, limiting protein intake to 80 grams per day, is not a primary dietary concern for hypertension. Choice D, limiting fluid intake to 1,500 mL per day, is not a standard recommendation for hypertension management.

4. What is the most important nursing intervention for a patient experiencing an acute asthma attack?

• A. Administer bronchodilators
• B. Provide supplemental oxygen
• C. Start IV fluids
• D. Monitor oxygen saturation

Correct answer: A

Rationale: The correct answer is to administer bronchodilators. During an acute asthma attack, bronchodilators like albuterol are crucial to help dilate the airways and improve breathing. Providing supplemental oxygen (Choice B) may be necessary but is not the priority intervention. Starting IV fluids (Choice C) and monitoring oxygen saturation (Choice D) are important aspects of care but are not the most critical interventions during an acute asthma attack.

5. A nurse is providing teaching to a client who has osteoporosis. Which of the following instructions should the nurse include?

• A. Take a calcium supplement once daily.
• B. Walk for 30 minutes three times per week.
• C. Avoid weight-bearing exercises.
• D. Increase intake of vitamin D.

Correct answer: B

Rationale: The correct answer is B. Walking regularly is beneficial for clients with osteoporosis as it helps maintain bone density and prevent fractures. Choice A is not the most appropriate because clients with osteoporosis often require more than just calcium supplements. Choice C is incorrect as weight-bearing exercises actually help strengthen bones. Choice D is important, but walking regularly has a more direct impact on bone health in clients with osteoporosis.

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