Nursing Elites

1. A nurse is contributing to the plan of care for an older adult client who has difficulty sleeping. Which of the following interventions should the nurse include?

• A. Give a bedtime snack
• B. Encourage a short nap in the afternoon
• C. Encourage exercise right before bed
• D. Establish a regular exercise routine 2 hours or more before bedtime

Correct answer: D

Rationale: The correct answer is D. Establishing a regular exercise routine at least 2 hours before bedtime promotes better sleep in older adults. Giving a bedtime snack (choice A) may disrupt sleep due to digestion, encouraging a short nap in the afternoon (choice B) can interfere with nighttime sleep, and encouraging exercise right before bed (choice C) can increase alertness and make it harder to fall asleep.

2. What are the common complications of diabetes, and how should they be managed?

• A. Retinopathy and nephropathy; manage with regular screening
• B. Neuropathy and cardiovascular disease; manage with medication
• C. Foot ulcers and hypertension; manage with proper foot care
• D. Hypertension and liver disease; manage with insulin therapy

Correct answer: A

Rationale: The correct answer is A. Common complications of diabetes include retinopathy (damage to the retina) and nephropathy (kidney damage). These complications can be managed effectively with regular screening to detect any signs early on. Choice B is incorrect as neuropathy and cardiovascular disease are other complications of diabetes but are managed through various treatments and lifestyle modifications, not just medication. Choice C is incorrect as although foot ulcers and hypertension are associated with diabetes, the management involves proper foot care practices and blood pressure control, respectively. Choice D is incorrect as hypertension and liver disease are not the typical complications of diabetes, and insulin therapy is not the primary management for these conditions.

3. A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following actions should the nurse take?

• A. Administer the TPN through a peripheral IV catheter.
• B. Check the client's capillary blood glucose level every 4 hours.
• C. Heat the TPN solution to room temperature before administering.
• D. Weigh the client every 3 days.

Correct answer: B

Rationale: The correct answer is to check the client's capillary blood glucose level every 4 hours. Clients receiving TPN are at risk for hyperglycemia, so regular monitoring of blood glucose levels is essential to detect and manage hyperglycemia promptly. Administering TPN through a peripheral IV catheter (Choice A) is incorrect as TPN should be given through a central venous catheter to prevent complications. Heating the TPN solution to room temperature (Choice C) is unnecessary and not a standard practice. Weighing the client every 3 days (Choice D) is important for monitoring fluid status but is not the priority action when caring for a client receiving TPN.

4. What lifestyle change should be emphasized for a client with hypertension?

• A. Increase intake of dairy products
• B. Reduce caffeine and sodium intake
• C. Eat carbohydrate-rich meals
• D. Limit intake of leafy green vegetables

Correct answer: B

Rationale: The correct lifestyle change that should be emphasized for a client with hypertension is to reduce caffeine and sodium intake. Caffeine can temporarily raise blood pressure, and high sodium intake is linked to increased blood pressure levels. Therefore, reducing these two components can help manage blood pressure in individuals with hypertension. Choices A, C, and D are incorrect because increasing intake of dairy products, consuming carbohydrate-rich meals, and limiting intake of leafy green vegetables do not specifically address the factors that contribute to high blood pressure in hypertension.

5. A client undergoing bariatric surgery is being taught about postoperative dietary changes by a nurse. Which statement by the client indicates an understanding of the teaching?

• A. I will drink carbonated beverages after surgery
• B. I will eat large meals after surgery
• C. I will avoid consuming solid foods for several weeks
• D. I will avoid taking small sips of liquids

Correct answer: C

Rationale: The correct answer is C because avoiding solid foods after bariatric surgery is crucial to prevent complications and promote healing. Choice A is incorrect as carbonated beverages can cause discomfort and should be avoided. Choice B is incorrect as large meals are not suitable after bariatric surgery. Choice D is incorrect as taking small sips of liquids is encouraged to prevent dehydration and promote recovery.

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