Nursing Elites

1. A nurse is caring for a client with Alzheimer’s disease. Which action should the nurse include in the plan of care to support the client’s cognitive function?

• A. Place a daily calendar in the kitchen
• B. Replace buttoned clothing with zippered items
• C. Replace the carpet with hardwood floors
• D. Create variation in the daily routine

Correct answer: A

Rationale: Placing a daily calendar in the kitchen is essential to help clients with Alzheimer's stay oriented to time and maintain cognitive function. It supports their ability to recall the day, date, and upcoming events, promoting a sense of control over their environment. Choices B, C, and D do not directly target cognitive function support in clients with Alzheimer's disease. While replacing buttoned clothing with zippered items may aid in dressing independently, changing the flooring or introducing variation in the daily routine does not specifically address cognitive function support.

2. A healthcare professional is completing a nutritional assessment on a client and measures body mass index (BMI). Which of the following readings correlates with a BMI of an overweight client?

• A. 18.5
• B. 24.9
• C. 25
• D. 32

Correct answer: C

Rationale: A BMI of 25-29.9 is considered overweight. Therefore, a BMI of 25 correlates with an overweight client. A BMI of 18.5-24.9 indicates a healthy weight. Choices A, B, and D are incorrect as they fall into the healthy weight or obese categories, not overweight.

3. A healthcare provider is preparing to administer a dose of levothyroxine. Which of the following should the healthcare provider do?

• A. Give it with food
• B. Assess the patient's heart rate
• C. Administer it in the evening
• D. Give it with calcium supplements

Correct answer: B

Rationale: The correct answer is to assess the patient's heart rate. Levothyroxine is a thyroid hormone replacement medication that can increase metabolism. One of the potential side effects of levothyroxine is tachycardia (rapid heart rate). Therefore, it is essential for the healthcare provider to assess the patient's heart rate before administering the medication to monitor for any signs of tachycardia. Giving levothyroxine with food may affect its absorption, so it is typically recommended to administer it on an empty stomach. Administering it in the evening is not necessary unless specifically prescribed by the healthcare provider, and giving it with calcium supplements can interfere with the absorption of levothyroxine.

4. A nurse on a pediatric care unit is delegating client care. Which of the following tasks should the nurse delegate to an assistive personnel?

• A. Initiate a dietary consult for a toddler
• B. Administer a glycerin suppository to a preschool-age child
• C. Evaluate gastric residual following intermittent feeding of an adolescent
• D. Transport a school-age child to x-ray

Correct answer: D

Rationale: The correct answer is D because transporting a stable child to x-ray is a task that can be safely delegated to an assistive personnel. This task does not require clinical judgment or specialized skills. Choices A, B, and C involve assessments and interventions that require nursing judgment and should be performed by a qualified nurse. Initiating a dietary consult for a toddler involves assessing the child's nutritional needs and must be done by a nurse. Administering a glycerin suppository to a preschool-age child requires medication administration skills and knowledge of appropriate dosages, which are within the nurse's scope of practice. Evaluating gastric residual following intermittent feeding of an adolescent is a clinical assessment that requires interpretation and decision-making based on the findings, making it a nursing responsibility.

5. A healthcare professional is preparing to administer morphine for severe pain. What is the priority assessment the professional should make before administration?

• A. Blood pressure
• B. Respiratory rate
• C. Heart rate
• D. Temperature

Correct answer: B

Rationale: Before administering morphine, the priority assessment the healthcare professional should make is the client's respiratory rate. Morphine can cause respiratory depression, so assessing the respiratory rate is crucial to prevent any potential complications. Assessing blood pressure, heart rate, and temperature are important as well, but they are not the priority when administering morphine for severe pain.

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