Nursing Elites

1. A client is being cared for by a nurse with dehydration. What is the priority intervention?

• A. Administer antiemetics to reduce nausea
• B. Encourage the client to drink oral rehydration solutions
• C. Monitor the client's fluid and electrolyte levels
• D. Administer intravenous fluids

Correct answer: C

Rationale: The correct answer is to monitor the client's fluid and electrolyte levels. When caring for a client with dehydration, it is crucial to assess and monitor their fluid and electrolyte status to guide appropriate interventions. Administering antiemetics may help with nausea but does not address the underlying issue of dehydration. Encouraging the client to drink oral rehydration solutions is beneficial but may not be the immediate priority if the client is severely dehydrated. Administering intravenous fluids may be necessary based on the assessment of fluid and electrolyte levels, making monitoring these levels the priority intervention.

2. What is the proper technique for administering an intramuscular (IM) injection?

• A. Locate the injection site and insert at 90 degrees
• B. Insert needle at a 45-degree angle
• C. Massage the site after injection
• D. Insert needle at a 15-degree angle

Correct answer: A

Rationale: The correct technique for administering an intramuscular (IM) injection is to locate the injection site and insert the needle at a 90-degree angle. This angle ensures that the medication is delivered into the muscle for proper absorption. Choice B is incorrect because a 45-degree angle is typically used for subcutaneous injections, not intramuscular. Choice C is incorrect as massaging the site after an injection can cause the medication to disperse unevenly. Choice D is incorrect as a 15-degree angle would not reach the muscle layer effectively for an IM injection.

3. What are the complications of untreated fluid overload?

• A. Pulmonary edema and congestive heart failure
• B. Hypertension and electrolyte imbalance
• C. Liver failure and electrolyte imbalance
• D. Pulmonary embolism and dehydration

Correct answer: A

Rationale: Corrected Rationale: Untreated fluid overload can lead to complications such as pulmonary edema and congestive heart failure. Pulmonary edema occurs when excess fluid accumulates in the lungs, leading to difficulty breathing and potentially life-threatening respiratory distress. Congestive heart failure can result from the heart's inability to pump effectively due to the excess fluid volume, leading to symptoms such as fatigue, shortness of breath, and fluid retention. Choices B, C, and D are incorrect because hypertension, liver failure, pulmonary embolism, and dehydration are not the primary complications directly associated with untreated fluid overload.

4. Which of the following interventions is most appropriate for a client with a pressure ulcer who has a low albumin level?

• A. Increase protein intake to improve healing
• B. Consult with a dietitian to create a high-protein diet
• C. Provide nutritional supplements
• D. Increase IV fluid intake to improve hydration

Correct answer: B

Rationale: Consulting with a dietitian to create a high-protein diet is the most appropriate intervention for a client with a pressure ulcer and low albumin level. This intervention can help address the client's poor nutritional status, support wound healing, and specifically target the low albumin level. Increasing protein intake alone (Choice A) may not be sufficient without proper guidance. Providing nutritional supplements (Choice C) can be beneficial but consulting with a dietitian for a personalized plan is more effective in this case. Increasing IV fluid intake (Choice D) primarily targets hydration and may not directly address the underlying issue of low albumin and poor nutritional status.

5. A client receiving chemotherapy is experiencing fatigue. Which intervention should the nurse implement to manage the client's fatigue?

• A. Encourage the client to take short naps during the day
• B. Instruct the client to remain on bedrest
• C. Provide the client with a high-calorie diet
• D. Encourage the client to increase activity levels

Correct answer: A

Rationale: The correct intervention to manage fatigue in a client receiving chemotherapy is to encourage the client to take short naps during the day. Fatigue is a common side effect of chemotherapy, and allowing the client to rest can help combat this symptom. Instructing the client to remain on bedrest (Choice B) is not recommended as it may lead to deconditioning and worsen fatigue. Providing a high-calorie diet (Choice C) may be beneficial for overall nutrition but does not directly address fatigue. Encouraging the client to increase activity levels (Choice D) may exacerbate fatigue instead of alleviating it.

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