Nursing Elites

1. A nurse is caring for a client with lung cancer who is experiencing dyspnea. Which intervention is most appropriate?

• A. Administer a cough suppressant to reduce discomfort.
• B. Encourage the client to lie flat to ease breathing.
• C. Provide supplemental oxygen therapy.
• D. Encourage deep breathing and coughing exercises.

Correct answer: C

Rationale: The most appropriate intervention for a client with lung cancer experiencing dyspnea is to provide supplemental oxygen therapy. This intervention helps improve oxygenation and alleviate breathing difficulties. Administering a cough suppressant (Choice A) may not address the underlying cause of dyspnea and can potentially depress the respiratory drive. Encouraging the client to lie flat (Choice B) can worsen dyspnea by reducing lung expansion. Encouraging deep breathing and coughing exercises (Choice D) may be beneficial in some situations, but when a client is experiencing dyspnea due to lung cancer, supplemental oxygen therapy is the priority to improve oxygen levels and alleviate breathing difficulty.

2. Which of the following types of vitamin or mineral deficiency can cause megaloblastic anemia and is associated with lower extremity paresthesias?

• A. Vitamin B12
• B. Folate
• C. Iron
• D. Vitamin K

Correct answer: A

Rationale: The correct answer is Vitamin B12. Vitamin B12 deficiency can lead to megaloblastic anemia, a condition characterized by the production of abnormally large and immature red blood cells. Lower extremity paresthesias, such as tingling or numbness, are common neurological symptoms associated with vitamin B12 deficiency. Folate deficiency can also cause megaloblastic anemia but is not typically linked to lower extremity paresthesias. Iron deficiency leads to microcytic anemia, not megaloblastic anemia. Vitamin K deficiency is associated with bleeding tendencies, not megaloblastic anemia or paresthesias.

3. What specific instructions should the nurse provide for proper administration of alendronate (Fosamax) in a patient with osteoporosis?

• A. Take the medication with milk to enhance calcium absorption.
• B. Take the medication with a full glass of water and remain upright for at least 30 minutes.
• C. Take the medication at bedtime to ensure absorption during sleep.
• D. Take the medication with food to prevent gastrointestinal upset.

Correct answer: B

Rationale: The correct answer is to take alendronate with a full glass of water and remain upright for at least 30 minutes. This is essential to prevent esophageal irritation and ensure proper drug absorption. Choice A is incorrect as alendronate should not be taken with milk due to potential interactions. Choice C is incorrect as there is no need to take the medication at bedtime specifically. Choice D is incorrect as taking alendronate with food can decrease its absorption.

4. What is a common factor related to all forms of heart failure?

• A. Peripheral edema
• B. Pulmonary edema
• C. Reduced cardiac output
• D. Jugular vein distention

Correct answer: C

Rationale: The correct answer is C: Reduced cardiac output. All forms of heart failure share this common factor, which occurs when the heart is unable to pump enough blood to meet the body's needs. Choices A, B, and D are incorrect. While peripheral edema and pulmonary edema can be symptoms of heart failure, they are not universal to all forms. Jugular vein distention is a sign of right heart failure, not a common factor across all types of heart failure.

5. A client presents to the emergency department with lower right quadrant abdominal pain, fever, nausea, and occasional diarrhea. After palpating the abdomen, the client displays tenderness. What would the nurse anticipate the client to be experiencing?

• A. Pseudomembranous colitis
• B. Peptic ulcer disease
• C. Appendicitis
• D. Esophageal cancer

Correct answer: C

Rationale: The correct answer is C: Appendicitis. The symptoms described - lower right quadrant abdominal pain, fever, nausea, diarrhea, and tenderness upon palpation - are classic signs of appendicitis. Appendicitis is an inflammatory condition of the appendix that often presents with these symptoms and requires immediate medical attention. Choice A, Pseudomembranous colitis, typically presents with watery diarrhea and is associated with antibiotic use. Choice B, Peptic ulcer disease, commonly presents with epigastric pain related to meals and can be accompanied by nausea or vomiting, but it does not typically cause right lower quadrant pain. Choice D, Esophageal cancer, usually presents with symptoms related to swallowing difficulties, weight loss, and sometimes chest pain, but it is not associated with the symptoms described in the scenario.

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