Nursing Elites

1. A client is receiving discharge teaching after a total hip arthroplasty. Which of the following instructions should be included?

• A. Cross your legs at the ankles while sitting
• B. Avoid bending your hips more than 90 degrees
• C. Sit in a low-seated chair
• D. Twist your body when standing up

Correct answer: B

Rationale: To prevent dislocation of the hip prosthesis, the client should avoid bending their hips more than 90 degrees. Excessive bending at the hips can increase the risk of hip dislocation, which is a significant concern following total hip arthroplasty. Sitting with crossed legs at the ankles (choice A) can also increase the risk of hip dislocation and should be avoided. Sitting in a low-seated chair (choice C) can make it more challenging for the client to stand up safely. Twisting the body when standing up (choice D) can also strain the hip joint and increase the risk of dislocation. Therefore, the correct instruction to include during discharge teaching is to avoid bending the hips more than 90 degrees.

2. A healthcare professional is providing discharge teaching to a client who has a new prescription for warfarin. Which of the following instructions should the healthcare professional include?

• A. Avoid drinking grapefruit juice.
• B. Take aspirin for pain relief.
• C. Consume a consistent amount of green leafy vegetables.
• D. Use an electric razor when shaving.

Correct answer: C

Rationale: Consuming a consistent amount of green leafy vegetables is important for clients taking warfarin as these foods contain vitamin K, which can affect the medication's effectiveness. Maintaining a consistent intake helps stabilize the International Normalized Ratio (INR) levels, which is crucial for monitoring the blood's ability to clot properly while on warfarin therapy. Choices A, B, and D are incorrect. Avoiding grapefruit juice is generally recommended with certain medications due to its interaction with liver enzymes, which is not directly related to warfarin. Taking aspirin along with warfarin can increase the risk of bleeding. Using an electric razor when shaving is a safety precaution for those at risk of bleeding, but it is not directly related to the medication warfarin.

3. A client has a new diagnosis of hyperkalemia and is receiving teaching from a healthcare provider on dietary management. Which of the following statements should the healthcare provider include in the teaching?

• A. You should increase your intake of potassium-rich foods.
• B. You should decrease your intake of potassium-rich foods.
• C. You should avoid foods that contain lactose.
• D. You should increase your intake of dairy products.

Correct answer: B

Rationale: The correct answer is B: 'You should decrease your intake of potassium-rich foods.' Hyperkalemia is a condition characterized by excess potassium in the blood. To manage hyperkalemia effectively, it is crucial to reduce the intake of potassium-rich foods. This helps in lowering the overall potassium levels in the body and prevents complications associated with hyperkalemia. Choices A, C, and D are incorrect. Increasing the intake of potassium-rich foods (Choice A) would exacerbate hyperkalemia. Avoiding foods that contain lactose (Choice C) is not directly related to managing hyperkalemia. Increasing the intake of dairy products (Choice D) is not recommended as they can be a significant source of dietary potassium.

4. A client with chronic obstructive pulmonary disease (COPD) is being cared for by a nurse. Which of the following interventions should the nurse include in the plan of care?

• A. Encourage pursed-lip breathing.
• B. Administer oxygen at 6 L/min via nasal cannula.
• C. Place the client in a supine position.
• D. Restrict fluid intake to less than 1,500 mL/day.

Correct answer: A

Rationale: Encouraging pursed-lip breathing is essential for clients with COPD as it aids in improving ventilation and gas exchange. This technique helps keep the airways open longer during exhalation, preventing air trapping and promoting more effective breathing. Administering oxygen, placing the client in a supine position, or restricting fluid intake are not primary interventions for managing COPD and may not address the specific respiratory needs of the client.

5. A healthcare professional is preparing to administer medications to a client who has an NG tube for continuous feedings. Which of the following actions should the healthcare professional take?

• A. Add crushed medications to the enteral feeding.
• B. Infuse each medication by gravity.
• C. Administer the medications through a syringe.
• D. Flush the NG tube with 5 mL of sterile water.

Correct answer: C

Rationale: Administering medications through a syringe is the correct action to take when a client has an NG tube for continuous feedings. This method ensures that each medication is delivered correctly and is not mixed with the enteral feeding, preventing drug interactions and ensuring proper administration of each medication. Adding crushed medications to the enteral feeding (Choice A) can lead to inaccurate dosing and potential drug interactions. Infusing each medication by gravity (Choice B) is not recommended as it may not ensure accurate delivery of the medication. Flushing the NG tube with sterile water (Choice D) is important but is not directly related to administering medications through the tube.

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