Nursing Elites

1. During a prenatal class for expectant mothers, what topic should be included to ensure the health of both the mother and the baby?

• A. importance of taking prenatal vitamins
• B. how to handle common discomforts of pregnancy
• C. preparing for labor and delivery
• D. breastfeeding techniques

Correct answer: A

Rationale: The correct answer is the importance of taking prenatal vitamins. Prenatal vitamins are crucial for the health of both the mother and the baby as they provide essential nutrients required for fetal development. While handling common discomforts of pregnancy (choice B) is important for maternal well-being, it does not directly impact the health of the baby. Preparing for labor and delivery (choice C) focuses more on the delivery process rather than the overall health of the mother and baby during pregnancy. Breastfeeding techniques (choice D) are relevant postpartum, not during the prenatal period, and do not directly impact the health of the baby during pregnancy.

2. The nurse is preparing to administer an oral medication to a client with dysphagia. Which action should the nurse take?

• A. Crush the medication and mix it with applesauce.
• B. Have the client drink a full glass of water with the medication.
• C. Administer the medication with a small amount of pudding.
• D. Place the medication at the back of the client's tongue.

Correct answer: C

Rationale: The correct action for the nurse to take when administering oral medication to a client with dysphagia is to administer the medication with a small amount of pudding. This method helps prevent aspiration in clients with dysphagia by ensuring easier swallowing. Crushing the medication and mixing it with applesauce (Choice A) might alter the medication's efficacy. Having the client drink a full glass of water with the medication (Choice B) may not be suitable for a client with dysphagia as it can increase the risk of aspiration. Placing the medication at the back of the client's tongue (Choice D) can also lead to aspiration and is not recommended.

3. A client with a history of atrial fibrillation is receiving warfarin (Coumadin) therapy. Which laboratory result indicates that the therapy is effective?

• A. International normalized ratio (INR) of 1.0.
• B. Prothrombin time (PT) of 12 seconds.
• C. Partial thromboplastin time (PTT) of 60 seconds.
• D. International normalized ratio (INR) of 2.5.

Correct answer: D

Rationale: An International Normalized Ratio (INR) of 2.5 indicates that warfarin therapy is within the therapeutic range for a client with atrial fibrillation. A lower INR (such as 1.0) would suggest subtherapeutic levels, risking blood clots. Prothrombin time (PT) and partial thromboplastin time (PTT) are not specific to monitoring warfarin therapy.

4. Which client has the highest risk for developing community-acquired pneumonia?

• A. a 40-year-old first-grade teacher who works with underprivileged children
• B. a 75-year-old retired secretary with exercise-induced wheezing
• C. a 60-year-old homeless person who is an alcoholic and smokes
• D. a 35-year-old aerobics instructor who skips meals and eats only vegetables

Correct answer: C

Rationale: The correct answer is C, a 60-year-old homeless person who is an alcoholic and smokes. This client has the highest risk of developing community-acquired pneumonia due to multiple factors such as homelessness, substance abuse, and smoking. Homelessness can lead to poor living conditions and limited access to healthcare, increasing susceptibility to infections. Alcoholism and smoking weaken the immune system, making individuals more vulnerable to respiratory infections like pneumonia. Choices A, B, and D do not present the same level of risk factors for pneumonia compared to choice C.

5. The healthcare provider is preparing to administer an intravenous antibiotic to a client with a central venous catheter. Which action is most important?

• A. Flush the catheter with heparin.
• B. Change the dressing at the insertion site.
• C. Check for blood return before administering the antibiotic.
• D. Use sterile technique when accessing the catheter.

Correct answer: D

Rationale: Using sterile technique when accessing the catheter is crucial to prevent infection in clients with a central venous catheter. This action helps maintain asepsis and reduces the risk of introducing pathogens into the catheter system. Flushing the catheter with heparin helps prevent occlusion but is not as crucial as ensuring sterile technique. Changing the dressing at the insertion site is important for assessing the site's condition but does not directly impact the administration of the antibiotic. Checking for blood return is essential to ensure proper catheter function, but sterile technique takes precedence to prevent infections.

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