Nursing Elites

1. A nurse is planning care for a client who has Parkinson’s disease and is at risk for aspiration. Which of the following actions should the nurse include in the plan of care?

• A. Encourage the client to eat thin liquids
• B. Instruct the client to tilt their head forward when swallowing
• C. Give the client large pieces of food
• D. Have the client lie down after meals

Correct answer: B

Rationale: The correct action the nurse should include in the plan of care for a client with Parkinson’s disease at risk for aspiration is to instruct the client to tilt their head forward when swallowing. This action helps protect the airway and reduces the risk of aspiration in clients with impaired swallowing, which is common in Parkinson’s disease. Encouraging the client to eat thin liquids (Choice A) can increase the risk of aspiration as they are harder to control during swallowing. Giving the client large pieces of food (Choice C) can also increase the risk of choking and aspiration. Having the client lie down after meals (Choice D) can further increase the risk of aspiration due to the potential for reflux. Therefore, the best action to prevent aspiration in this situation is to instruct the client to tilt their head forward when swallowing.

2. A nurse is in an acute care facility, caring for a client who is postop following abdominal surgery. Which behavior should the nurse identify as increasing the client's risk for constipation?

• A. Increased fiber intake
• B. Suppression of the urge to defecate
• C. Ambulation twice a day
• D. Daily laxative use

Correct answer: B

Rationale: The correct answer is B: 'Suppression of the urge to defecate.' Suppressing the urge to defecate can lead to constipation, especially in postoperative clients. It is essential to encourage clients to respond to the urge to defecate to prevent constipation. Increased fiber intake (Choice A) is beneficial for preventing constipation. Ambulation (Choice C) helps promote bowel motility and can reduce the risk of constipation. Daily laxative use (Choice D) may contribute to laxative dependence but is not the behavior most directly associated with increasing the risk of constipation in this scenario.

3. A nurse is reviewing psychosocial stages of development for a school-age child. What would be an expected behavioral finding for this child?

• A. Personalize values and beliefs and base reasoning on ethical fairness principles.
• B. Develop a sense of personal identity that is influenced by family expectations.
• C. Develop a sense of industry through advances in learning.
• D. Take on new experiences and when unable to accomplish tasks, may feel guilty.

Correct answer: C

Rationale: The correct answer is C. School-age children (6-12 years) are in Erikson's stage of industry vs. inferiority. During this stage, they strive to develop a sense of industry through learning and socialization. They seek to excel in various areas, such as schoolwork or activities, and look for approval from peers and adults. Choices A, B, and D are incorrect because personalizing values and beliefs, developing personal identity influenced by family expectations, and feeling guilty for inability to accomplish tasks are not typical behavioral findings for a school-age child in the context of psychosocial development.

4. A nurse is caring for a client newly prescribed doxazosin mesylate. Which of the following instructions should the nurse include in client education regarding taking the first dose of this medication?

• A. Change positions slowly and lie down if dizziness occurs
• B. There is no need to avoid normal activities
• C. Avoid dairy products while taking this medication
• D. Do not eat green leafy vegetables

Correct answer: A

Rationale: The correct answer is A. Doxazosin can cause first-dose orthostatic hypotension, which may lead to dizziness or fainting when the client stands up too quickly. The nurse should advise the client to change positions slowly and lie down if dizziness occurs to prevent falls and other injuries. Choice B is incorrect because while the client can continue normal activities, caution should be taken with position changes. Choice C is incorrect as doxazosin does not interact with dairy products. Choice D is incorrect as there is no need to avoid green leafy vegetables specifically while taking doxazosin.

5. A nurse is caring for a 7-month-old infant being treated for severe dehydration. Which finding indicates treatment has been effective?

• A. Skin turgor displays tenting
• B. Flat anterior fontanel
• C. Cool, mottled skin
• D. Hyperpnea

Correct answer: B

Rationale: A flat anterior fontanel indicates improved hydration in infants, as dehydration typically causes sunken fontanels.

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