Nursing Elites

1. A client is grieving the loss of her partner and expresses thoughts of not seeing the point of living anymore. What action should the nurse take?

• A. Recommend that the client seek spiritual guidance
• B. Request additional support from the client's family
• C. Tell the client that this is a normal response to grief
• D. Ask the client if she plans to harm herself

Correct answer: D

Rationale: When a client expresses feelings of hopelessness or worthlessness, it is crucial for the nurse to assess for suicidal ideation. Asking the client directly if she plans to harm herself is essential to determine the level of risk and ensure appropriate interventions are implemented. Recommending spiritual guidance (Choice A) may not address the immediate safety concerns related to suicidal ideation. Requesting additional support from the client's family (Choice B) is not as direct in addressing the client's safety. While stating that the client's response is a normal part of grief (Choice C) may provide validation, it does not address the potential risk of harm to the client.

2. A client with rheumatoid arthritis is prescribed prednisone. What information should the LPN/LVN include when teaching the client about this medication?

• A. Take the medication with food to minimize gastrointestinal side effects.
• B. Avoid exposure to sunlight while taking this medication.
• C. Do not discontinue the medication abruptly.
• D. Increase fluid intake while taking this medication.

Correct answer: C

Rationale: The correct answer is C: 'Do not discontinue the medication abruptly.' It is crucial for clients prescribed prednisone to not stop the medication suddenly to prevent adrenal insufficiency, as this medication suppresses the body's natural production of cortisol. Choice A is incorrect because prednisone should be taken with food to minimize gastrointestinal side effects, not necessarily to prevent stomach upset. Choice B is incorrect as there is no specific need to avoid sunlight while taking prednisone. Choice D is not directly related to prednisone use; while adequate fluid intake is generally beneficial, it is not a specific instruction for prednisone administration.

3. Which of the following should a group of community health nurses plan as part of a primary prevention program for occupational pulmonary diseases?

• A. Screening for early symptoms
• B. Providing treatment for diagnosed conditions
• C. Elimination of the exposure
• D. Increasing awareness of symptoms

Correct answer: C

Rationale: The correct answer is C: 'Elimination of the exposure.' Primary prevention programs for occupational pulmonary diseases aim to prevent the development of these diseases by eliminating or minimizing exposure to harmful substances in the workplace. Screening for early symptoms (Choice A) focuses on secondary prevention, detecting diseases at an early stage. Providing treatment for diagnosed conditions (Choice B) is part of tertiary prevention, managing and treating established diseases. Increasing awareness of symptoms (Choice D) may help in early detection but does not directly address the prevention of exposure, which is crucial for primary prevention of occupational pulmonary diseases.

4. When should discharge planning for a patient admitted to the neurological unit with a diagnosis of stroke begin?

• A. At the time of admission
• B. The day before the patient is to be discharged
• C. When outpatient therapy is no longer needed
• D. As soon as the patient's discharge destination is known

Correct answer: A

Rationale: Discharge planning for a patient admitted to the neurological unit with a stroke diagnosis should begin at the time of admission. Initiating discharge planning early allows for a comprehensive assessment of the patient's needs, enables better coordination of care, and ensures a smooth transition from the hospital to the next level of care. Option B is incorrect because waiting until the day before discharge does not provide enough time for adequate planning. Option C is incorrect because waiting until outpatient therapy is no longer needed delays the planning process. Option D is incorrect because waiting until the discharge destination is known may result in rushed planning and inadequate preparation for the patient's needs.

5. A client who is malnourished expresses concern about losing their loose wedding ring. What is the most appropriate action for the nurse to take?

• A. I can pin it to your hospital gown to prevent it from falling off.
• B. I will place it in your drawer to keep it safe.
• C. I will hold onto it until a family member can retrieve it.
• D. I can put it in a locked storage unit for you.

Correct answer: D

Rationale: The most appropriate action for the nurse to take is to put the client's wedding ring in a locked storage unit for safekeeping. This ensures that the ring is secure and minimizes the risk of loss or damage. Choices A, B, and C do not provide the same level of security and protection as placing the ring in a locked storage unit. Pinning it to the hospital gown (Choice A) may not be secure and could still lead to loss. Placing it in the client's drawer (Choice B) may not guarantee its safety. Holding onto it until a family member retrieves it (Choice C) leaves the ring vulnerable to misplacement or theft.

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