Nursing Elites

1. A client is experiencing an acute exacerbation of Crohn's disease. Which of the following actions should the nurse take?

• A. Encourage the client to increase dietary fiber.
• B. Maintain the client on a low-residue diet.
• C. Provide the client with frequent high-calorie snacks.
• D. Encourage the client to eat a high-fiber diet.

Correct answer: B

Rationale: During an acute exacerbation of Crohn's disease, the nurse should maintain the client on a low-residue diet. This diet helps to minimize bowel irritation by reducing the volume and frequency of stools. Choices A, C, and D are incorrect. Encouraging the client to increase dietary fiber (Choice A) and eat a high-fiber diet (Choice D) can worsen symptoms and aggravate bowel inflammation in Crohn's disease. Providing the client with frequent high-calorie snacks (Choice C) may not be appropriate during an exacerbation since high-fat foods can be harder to digest and may exacerbate symptoms.

2. A client has a new prescription for digoxin. Which of the following instructions should the nurse include?

• A. Take this medication with food to prevent nausea.
• B. Notify your provider if you experience visual disturbances.
• C. Take an antacid with this medication if indigestion occurs.
• D. Avoid taking this medication if your heart rate is less than 60/min.

Correct answer: B

Rationale: The correct instruction for a client taking digoxin is to notify their provider if they experience visual disturbances. Visual disturbances can be a sign of digoxin toxicity, and prompt notification to the healthcare provider is essential for timely intervention. Choice A is incorrect because digoxin should be taken on an empty stomach for better absorption. Choice C is incorrect because antacids can interfere with the absorption of digoxin. Choice D is incorrect because a heart rate less than 60/min is not a sole reason to avoid taking digoxin; rather, it is important to monitor the heart rate and consult with the healthcare provider if there are concerns.

3. What is the primary nursing intervention for a patient experiencing hypoglycemia?

• A. Administer IV fluids
• B. Check blood sugar levels
• C. Provide oral glucose
• D. Recheck blood sugar levels in 15 minutes

Correct answer: D

Rationale: The correct answer is to recheck blood sugar levels in 15 minutes. This intervention is crucial to ensure that the hypoglycemia has been effectively corrected after the initial treatment. Administering IV fluids may be necessary in cases of severe dehydration but is not the primary intervention for hypoglycemia. Checking blood sugar levels is important, but the primary intervention should focus on treating the low blood sugar levels first, which is done by providing oral glucose. However, the most critical step after providing initial treatment is to recheck blood sugar levels to confirm that they have improved to safe levels.

4. What is the initial step when a patient is experiencing chest pain?

• A. Administer oxygen
• B. Reposition the patient
• C. Provide pain relief
• D. Provide nitroglycerin

Correct answer: A

Rationale: Administering oxygen is the initial step in managing chest pain. Oxygen helps improve oxygenation levels in the blood, which is crucial in cases of chest pain. Repositioning the patient, providing pain relief, or administering nitroglycerin may be necessary steps depending on the underlying cause, but administering oxygen takes precedence as it addresses the primary concern of oxygen supply to the body during chest pain.

5. A client who has a new diagnosis of tuberculosis should be placed in which type of room to prevent the spread of airborne pathogens?

• A. Administer isoniazid by mouth daily.
• B. Place the client in droplet isolation.
• C. Wear a surgical mask when transporting the client.
• D. Place the client in a negative pressure room.

Correct answer: D

Rationale: Clients diagnosed with tuberculosis should be placed in a negative pressure room to prevent the spread of airborne pathogens. Option A is incorrect because administering isoniazid is a treatment for tuberculosis, not a preventive measure related to infection control. Option B is incorrect as droplet isolation is used for diseases transmitted through respiratory droplets, not airborne pathogens like tuberculosis. Option C is incorrect as wearing a surgical mask is not sufficient to prevent the spread of tuberculosis in healthcare settings; placing the client in a negative pressure room is the most effective measure.

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