Nursing Elites

1. A client with hypertension is receiving lifestyle education from a nurse. What should be emphasized?

• A. Encourage a low-sodium diet
• B. Advise the client to avoid caffeinated drinks
• C. Recommend increasing high-protein foods
• D. Advise the client to reduce fat intake

Correct answer: B

Rationale: The correct answer is to advise the client to avoid caffeinated drinks. Caffeine can temporarily increase blood pressure, so avoiding caffeinated drinks can help manage hypertension. Encouraging a low-sodium diet (Choice A) is essential for hypertension management as excess sodium can raise blood pressure. Increasing high-protein foods (Choice C) is not a primary focus in managing hypertension. While reducing fat intake (Choice D) can be beneficial for overall health, it is not the priority in lifestyle modifications for hypertension.

2. A nurse is caring for a client who is 1 day postoperative and is unable to ambulate. Which of the following actions should the nurse take to promote the client's venous return?

• A. Encourage deep breathing exercises
• B. Maintain the client in a supine position
• C. Apply a sequential compression device
• D. Massage the client's legs

Correct answer: C

Rationale: The correct answer is C: Apply a sequential compression device. Applying a sequential compression device promotes venous return by assisting with blood circulation in the lower extremities, reducing the risk of blood clots. Encouraging deep breathing exercises can help with lung expansion but does not directly promote venous return. Maintaining the client in a supine position may not be ideal for promoting venous return if the client is unable to move. Massaging the client's legs may be contraindicated postoperatively due to the risk of dislodging a clot or causing trauma to the surgical site.

3. A nurse is contributing to the plan of care for a client who is at risk of developing pressure injuries. Which of the following interventions should the nurse include?

• A. Place the client in a prone position
• B. Place the client in a 30-degree lateral position
• C. Encourage the client to reposition every 4 hours
• D. Place the client in a high Fowler's position

Correct answer: B

Rationale: The correct answer is B: Place the client in a 30-degree lateral position. Positioning the client laterally reduces pressure on bony prominences, improving circulation and helping prevent pressure injuries. Placing the client in a prone position (choice A) increases pressure on the bony prominences, raising the risk of pressure injuries. Similarly, placing the client in a high Fowler's position (choice D) can also increase pressure on certain areas. While encouraging the client to reposition every 4 hours (choice C) is important, the specific lateral positioning is more beneficial in preventing pressure injuries.

4. What are the signs and symptoms of a pulmonary embolism?

• A. Sudden shortness of breath
• B. Chest pain
• C. Cough with blood
• D. All of the above

Correct answer: D

Rationale: A pulmonary embolism can manifest with sudden shortness of breath, chest pain, and coughing up blood. These symptoms are classic presentations of a pulmonary embolism due to the blockage of blood flow to the lungs. Therefore, the correct answer is 'All of the above.' Each symptom alone can be seen in various other conditions, but when occurring together, they strongly suggest a pulmonary embolism. Sudden shortness of breath is due to decreased oxygenation, chest pain can result from the strain on the heart, and coughing with blood may indicate damage to the lung tissue. Choosing any single symptom would not encompass the full range of presentations seen in a pulmonary embolism.

5. A nurse is preparing to administer metoclopramide 10 mg IM. Available is metoclopramide 5 mg/mL. How many mL should the nurse administer?

• A. 1 mL
• B. 2 mL
• C. 3 mL
• D. 4 mL

Correct answer: B

Rationale: To administer 10 mg of metoclopramide, the nurse should administer 2 mL (10 mg / 5 mg per mL). Therefore, the correct answer is 2 mL. Choice A (1 mL) is incorrect because it would only deliver 5 mg of metoclopramide, which is half the required dose. Choice C (3 mL) and D (4 mL) are incorrect as they would provide more than the required dose of 10 mg.

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