Nursing Elites

1. A patient is receiving discharge teaching for esophageal cancer and starting radiation therapy. What instruction should the healthcare provider include?

• A. Remove dye markings after each radiation treatment
• B. Apply a warm compress to the irradiated site
• C. Wear clothing over the area of radiation treatment
• D. Use a washcloth to bathe the treatment area

Correct answer: C

Rationale: The correct instruction for a patient starting radiation therapy for esophageal cancer is to wear clothing over the area of radiation treatment. This helps to prevent irritation and protect the skin. Removing dye markings after each treatment (choice A) is unnecessary and not typically part of the patient's self-care. Applying a warm compress (choice B) can exacerbate skin irritation caused by radiation. Using a washcloth to bathe the treatment area (choice D) can potentially irritate the skin further, making it important to avoid.

2. A client has been taking propranolol. Which of the following findings indicates a need to withhold the medication?

• A. Sodium 130 mEq/L
• B. Blood pressure 156/90 mm Hg
• C. Potassium 5.2 mEq/L
• D. Pulse 54/min

Correct answer: D

Rationale: A pulse of 54/min indicates bradycardia, which is a side effect of propranolol, a beta-blocker. The medication should be withheld if the client's pulse drops below 60/min. The other findings (sodium levels, blood pressure, and potassium levels) are not directly indicative of the need to withhold propranolol.

3. A client with chronic kidney disease is being educated by a nurse about managing their condition. Which of the following statements shows an understanding of the teaching?

• A. I will need to take an iron supplement.
• B. I will consume foods high in phosphorus.
• C. I will reduce my intake of carbohydrates.
• D. I will monitor my blood glucose level daily.

Correct answer: A

Rationale: The correct answer is A. Clients with chronic kidney disease often develop anemia due to reduced erythropoietin production, leading to decreased red blood cell production. Iron supplementation is frequently required to enhance red blood cell production. Choices B, C, and D are incorrect because in chronic kidney disease, there is a need to restrict phosphorus intake, control carbohydrate intake for blood sugar management, and monitor electrolytes and fluid balance rather than blood glucose levels.

4. A client has been prescribed metformin. What should be included in the teaching?

• A. It can cause weight gain
• B. Take it with food
• C. It is an insulin
• D. Monitor for hyperglycemia

Correct answer: B

Rationale: The correct answer is to take metformin with food. This is important to minimize gastrointestinal side effects and improve absorption. Choice A is incorrect as metformin is not typically associated with weight gain. Choice C is wrong as metformin is not an insulin but a medication that helps control blood sugar levels. Choice D is also incorrect as metformin is not known to cause hyperglycemia.

5. What is the first action when a client who is admitted with schizophrenia reports hearing voices telling them to harm themselves?

• A. Administer antipsychotic medication
• B. Ask the client what the voices are saying
• C. Distract the client with another activity
• D. Call the healthcare provider

Correct answer: B

Rationale: The correct first action when a client with schizophrenia reports hearing voices telling them to harm themselves is to ask the client what the voices are saying. This is important to assess the content of the hallucinations and determine if there is any immediate danger or suicidal intent. Administering antipsychotic medication without knowing the content of the voices or the level of danger could be inappropriate and potentially harmful. Distracting the client with another activity may not address the underlying issue of the hallucinations commanding harm. Calling the healthcare provider can be done after assessing the situation and gathering information from the client.

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