Nursing Elites

1. A client is being discharged two days after a mastectomy. Which of the following instructions should the nurse include?

• A. Wear a tight-fitting bra for support.
• B. Avoid lifting heavy objects for at least 6 weeks.
• C. Sleep on the affected side to promote healing.
• D. Begin arm exercises 24 hours after surgery.

Correct answer: B

Rationale: The correct answer is to instruct the client to avoid lifting heavy objects for at least 6 weeks after a mastectomy. This is important to prevent complications and promote proper healing. Choice A is incorrect because tight-fitting bras can increase the risk of lymphedema and discomfort. Choice C is incorrect as sleeping on the affected side can cause discomfort and interfere with healing. Choice D is incorrect as initiating arm exercises too soon after surgery can strain the surgical site and hinder recovery.

2. How should fluid balance be assessed in a patient receiving diuretics?

• A. Monitor daily weight
• B. Monitor intake and output
• C. Check for edema
• D. Monitor blood pressure

Correct answer: A

Rationale: Corrected Rationale: Monitoring daily weight is the most accurate method to assess fluid balance in patients receiving diuretics. Changes in weight reflect changes in fluid balance, making it a sensitive indicator. Monitoring intake and output (choice B) is important but may not provide a complete picture of overall fluid balance. Checking for edema (choice C) is a late sign of fluid imbalance and may not be sensitive enough to detect subtle changes. Monitoring blood pressure (choice D) is relevant but may not directly reflect fluid balance as it can be influenced by various other factors.

3. A client who has a new prescription for lisinopril is being taught by a nurse. Which of the following client statements indicates an understanding of the teaching?

• A. I should avoid using salt substitutes while taking this medication.
• B. I should take this medication with food to prevent nausea.
• C. I should increase my intake of potassium-rich foods while taking this medication.
• D. I should limit my fluid intake while taking this medication.

Correct answer: A

Rationale: The correct answer is A. Lisinopril can increase potassium levels, so clients should avoid salt substitutes that contain potassium. Choice B is incorrect because lisinopril is usually taken on an empty stomach. Choice C is incorrect because lisinopril can lead to hyperkalemia, so increasing potassium-rich foods is not recommended. Choice D is incorrect because lisinopril can cause increased urination, so fluid intake should not be limited.

4. A healthcare professional is preparing education material for a client. Which of the following techniques should the professional use in creating material?

• A. Emphasize important information using bold lettering.
• B. Use a 7th-grade reading level.
• C. Avoid using cartoons in the material.
• D. Use words with three or four syllables.

Correct answer: B

Rationale: The correct answer is to 'Use a 7th-grade reading level.' This ensures that the material is accessible to most clients by keeping the language simple and easy to understand. Emphasizing important information using bold lettering (Choice A) can be helpful but may not enhance overall readability. Avoiding cartoons (Choice C) is not a universal rule and can sometimes make the material more engaging. Using words with three or four syllables (Choice D) can make the material difficult to comprehend for many clients.

5. A nurse is assessing a client who is 48 hours postoperative following a hip replacement. Which of the following findings should the nurse report to the provider?

• A. Heart rate 90/min.
• B. WBC count 15,000/mm3.
• C. Urinary output 75 mL in the past 4 hours.
• D. Temperature 37.8°C (100°F).

Correct answer: B

Rationale: An elevated WBC count 48 hours postoperatively may indicate an infection and should be reported to the provider. Choice A, a heart rate of 90/min, is within normal limits and not a concerning finding postoperatively. Choice C, urinary output of 75 mL in the past 4 hours, may indicate decreased renal perfusion, but an elevated WBC count is a more urgent finding. Choice D, a temperature of 37.8°C (100°F), which is slightly elevated, could be indicative of the body's normal response to surgery and is not as alarming as an elevated WBC count.

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