Nursing Elites

1. A client reports difficulty sleeping at night, which interferes with daily functioning. Which intervention should the nurse suggest to this client?

• A. Avoid beverages containing caffeine
• B. Take a sleep medication regularly at bedtime
• C. Watch television for 30 minutes in bed to relax before falling asleep
• D. Advise the client to take several naps during the day

Correct answer: A

Rationale: The correct answer is A: Avoid beverages containing caffeine. Caffeine is a stimulant that can interfere with sleep, making it difficult for the client to fall asleep at night. Taking sleep medication regularly (choice B) may not address the root cause of the sleep difficulty and can lead to dependency. Watching television in bed (choice C) can actually stimulate the brain and hinder relaxation before sleep. Advising the client to take several naps during the day (choice D) can disrupt the sleep-wake cycle further. Therefore, recommending the avoidance of caffeine-containing beverages is the most appropriate intervention to help the client improve their ability to sleep at night and function better during the day.

2. A client has a new prescription for digoxin, and a nurse is providing teaching. Which of the following client statements indicates an understanding of the teaching?

• A. I will take my pulse before taking this medication.
• B. I will take this medication with an antacid.
• C. I will double the dose if I miss one.
• D. I will avoid eating bananas.

Correct answer: A

Rationale: The correct answer is A because taking the pulse before administering digoxin is crucial as the medication can cause bradycardia. Monitoring the pulse helps in identifying any signs of bradycardia, a common side effect of digoxin. Options B, C, and D are incorrect. Taking digoxin with an antacid may interfere with its absorption. Doubling the dose if a dose is missed can lead to overdose and adverse effects. Avoiding bananas is not specifically related to digoxin therapy.

3. A client has tuberculosis, and the nurse is planning care. Which of the following isolation precautions should the nurse implement?

• A. Protective environment
• B. Contact
• C. Airborne
• D. Droplet

Correct answer: C

Rationale: The correct answer is C: Airborne. Tuberculosis is transmitted through the air, making it an airborne disease. Airborne precautions are crucial to prevent the spread of tuberculosis to others. These precautions include placing the client in a negative pressure room, wearing an N95 respirator mask, and ensuring proper ventilation to minimize the risk of transmission to healthcare workers and other clients. Choice A, Protective environment, is used for clients with compromised immune systems. Choice B, Contact precautions, are used for diseases spread by direct or indirect contact. Choice D, Droplet precautions, are for diseases transmitted through respiratory droplets, like influenza or pertussis.

4. During an abdominal assessment, what is the correct sequence of steps for a healthcare provider to follow?

• A. Inspection, percussion, palpation, auscultation
• B. Percussion, auscultation, inspection, palpation
• C. Auscultation, palpation, inspection, percussion
• D. Inspection, auscultation, percussion, palpation

Correct answer: D

Rationale: During an abdominal assessment, the correct sequence of steps is inspection, auscultation, percussion, and palpation. This sequence is followed to prevent altering bowel sounds. Inspection allows for visual observation, followed by auscultation to listen for bowel sounds without causing disturbance, percussion to assess for tympany or dullness, and finally palpation to feel for any abnormalities or tenderness. Choice A is incorrect because palpation should come after percussion. Choice B is incorrect as auscultation should be performed after inspection. Choice C is incorrect because palpation should be the final step after percussion.

5. A client has a new diagnosis of hyperthyroidism and is being taught about dietary management. Which of the following statements should the nurse include in the teaching?

• A. You should increase your intake of iodine-rich foods.
• B. You should avoid foods that contain iodine.
• C. You should increase your intake of dairy products.
• D. You should avoid foods that contain gluten.

Correct answer: B

Rationale: The correct answer is B. In hyperthyroidism, it is advisable to avoid foods that contain iodine to help manage the condition and prevent complications. Excessive iodine intake can exacerbate hyperthyroidism symptoms by stimulating the thyroid gland. Therefore, the nurse should include information about avoiding iodine-rich foods in the client's dietary management teaching. Choices A, C, and D are incorrect because increasing intake of iodine-rich foods can worsen hyperthyroidism symptoms, increasing dairy products is not specific to managing hyperthyroidism, and avoiding gluten is more relevant for conditions like celiac disease, not hyperthyroidism.

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