Nursing Elites

1. A nurse is caring for a female client who has osteoporosis and a new prescription for raloxifene. What should the nurse assess prior to initiating therapy?

• A. Pregnancy status
• B. Bone density
• C. Calcium levels
• D. Blood pressure

Correct answer: A

Rationale: The correct answer is A: Pregnancy status. Raloxifene is a pregnancy category X drug, which means it can cause serious birth defects. Therefore, it is crucial for the nurse to assess the client's pregnancy status before initiating therapy. Choice B, bone density, while important in osteoporosis management, is not a specific concern related to initiating raloxifene therapy. Choice C, calcium levels, and choice D, blood pressure, are not directly related to the initiation of raloxifene therapy in a female client with osteoporosis.

2. When caring for a client's tracheostomy at home, which instruction should the nurse include in the teaching?

• A. Clean with alcohol
• B. Cover the tracheostomy when outside
• C. Replace the tube weekly
• D. Use tap water to clean

Correct answer: B

Rationale: Covering the tracheostomy when outside is crucial as it helps prevent dust and other irritants from entering the airway, reducing the risk of complications. Cleaning with alcohol (choice A) can be too harsh for the skin around the tracheostomy site. While replacing the tube weekly (choice C) is important, it is typically done by healthcare providers. Using tap water to clean (choice D) is not recommended as it may introduce contaminants to the tracheostomy site.

3. The nurse is assessing the patient for respiratory complications of immobility. What action should the nurse take?

• A. Auscultate the entire lung region to assess lung sounds.
• B. Assess the patient at least every 4 hours.
• C. Focus auscultation on the upper lung fields.
• D. Inspect chest wall movements primarily during the expiratory cycle.

Correct answer: A

Rationale: Auscultating the entire lung region is the most appropriate action when assessing a patient for respiratory complications related to immobility. This approach helps the nurse identify any abnormalities in lung sounds, such as diminished breath sounds or the presence of secretions. Assessing the patient at regular intervals (choice B) is important but does not specifically address the respiratory assessment needed in this situation. Focusing auscultation on the upper lung fields (choice C) may miss potential issues in other areas. Inspecting chest wall movements primarily during the expiratory cycle (choice D) is not the most effective way to assess lung sounds and identify respiratory complications.

4. When educating a patient with hypertension about lifestyle changes, what is the most crucial advice to provide?

• A. Advise the patient to reduce salt intake.
• B. Instruct the patient to limit alcohol consumption.
• C. Recommend the patient to exercise for 30 minutes every day.
• D. Instruct the patient to avoid high-cholesterol foods.

Correct answer: A

Rationale: The most critical lifestyle change for a patient with hypertension is to reduce salt intake. Excessive salt consumption can lead to increased blood pressure levels. While limiting alcohol consumption (Choice B) and regular exercise (Choice C) are also beneficial for managing hypertension, reducing salt intake has a more direct impact on blood pressure control. Avoiding high-cholesterol foods (Choice D) is important for heart health but may not have as significant an impact on blood pressure as reducing salt intake.

5. A healthcare professional suspects a colleague of diverting narcotics. What is the first step the healthcare professional should take?

• A. Confront the colleague directly
• B. Report the suspicion to the supervisor
• C. Ignore the issue and continue working
• D. Notify the pharmacy about the colleague's behavior

Correct answer: B

Rationale: The correct first step for a healthcare professional who suspects a colleague of diverting narcotics is to report the suspicion to the supervisor. This action is essential to protect patient safety, uphold ethical standards, and comply with legal obligations. Confronting the colleague directly may not only escalate the situation but also jeopardize the investigation process. Ignoring the issue and continuing to work could potentially harm patients and violate professional responsibilities. Notifying the pharmacy, while important, should come after informing the appropriate supervisor or authority within the healthcare facility.

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