Nursing Elites

1. During passive range of motion (ROM) exercises, how should the nurse perform each movement for a patient with impaired mobility?

• A. The nurse moves each movement just to the point of resistance.
• B. The patient repeats each movement 5 times.
• C. The movement continues until the patient reports pain.
• D. The nurse completes each movement quickly and smoothly.

Correct answer: A

Rationale: During passive range of motion (ROM) exercises, the nurse is responsible for moving the patient's joints through their range of motion. The correct technique involves performing movements slowly and smoothly, only going to the point of resistance without causing pain. This technique helps maintain joint flexibility and prevent contractures. Choice A is the correct answer as it reflects the appropriate technique for passive ROM exercises. Choices B and C are incorrect because the patient is not actively participating, and ROM exercises should not cause pain. Choice D is incorrect as movements should be done deliberately and not quickly.

2. A client with heart failure is being taught by a nurse on reducing daily sodium intake. What is the most important factor in determining the client's ability to learn new dietary habits?

• A. The involvement of the client in planning the change
• B. The presence of a dietitian during the teaching
• C. The use of dietary supplements
• D. The client's family support

Correct answer: A

Rationale: The most crucial factor in the client's ability to learn new dietary habits is their involvement in planning the change. When clients actively participate in setting their dietary goals, they are more likely to commit to and adhere to the changes. This empowerment fosters a sense of ownership and responsibility, enhancing the chances of successful dietary modifications. The presence of a dietitian, use of dietary supplements, and family support, while beneficial, are not as critical as the client's active participation in planning the dietary changes.

3. A nurse is caring for an older adult client who is confused and continually grabs at the nurse. Which of the following is a nursing action?

• A. Firmly tell the client not to grab
• B. Redirect the client’s attention
• C. Use physical restraints
• D. Avoid contact with the client

Correct answer: B

Rationale: Redirecting the client's attention is the appropriate nursing action in this scenario. When dealing with a confused client exhibiting grabbing behavior, redirection can help shift their focus to a more appropriate activity or object. Firmly telling the client not to grab may escalate the situation and create a confrontational environment, which is not recommended when caring for confused clients. The use of physical restraints should be a last resort and only implemented after all other strategies have been exhausted, as they can contribute to increased agitation and distress in older adults. Avoiding contact with the client is not a proactive approach to managing the behavior and may lead to feelings of neglect or abandonment in the client.

4. The patient diagnosed with diabetes is reporting severe foot pain due to corns and has been using oval corn pads to self-treat the corns. Which information will the nurse share with the patient?

• A. Corn pads are an adequate treatment and should be continued.
• B. The patient should avoid soaking the feet before using a pumice stone.
• C. The current self-treatment is likely impeding circulation to the toes.
• D. Tighter shoes would help compress the corns and make them smaller.

Correct answer: C

Rationale: The nurse should inform the patient that using oval corn pads can increase pressure on the toes and impede circulation, which may exacerbate foot problems in patients with diabetes. It is important to avoid practices that restrict blood flow to the feet, as poor circulation can lead to serious complications. Soaking the feet and using a pumice stone can be beneficial for corns, but in this case, the current self-treatment with corn pads is not recommended. Tighter shoes would further increase pressure on the corns and should be avoided. Therefore, the nurse should emphasize the importance of proper foot care and recommend alternative treatments to promote foot health and prevent complications.

5. A healthcare professional is reviewing a client’s medications. They include cimetidine and imipramine. Knowing that cimetidine decreases the metabolism of imipramine, the healthcare professional should identify that this combination is likely to result in which of the following effects?

• A. Decreased therapeutic effects of cimetidine
• B. Increased risk of imipramine toxicity
• C. Decreased risk of adverse effects of cimetidine
• D. Increased therapeutic effects of imipramine

Correct answer: B

Rationale: When cimetidine decreases the metabolism of imipramine, it leads to an increased concentration of imipramine in the body, which can result in imipramine toxicity. This increased risk of toxicity is the likely effect of this drug interaction. Choice A is incorrect because cimetidine's effect on imipramine metabolism does not impact the therapeutic effects of cimetidine. Choice C is incorrect because the interaction does not decrease the risk of adverse effects of cimetidine. Choice D is incorrect as the increased concentration of imipramine can lead to toxicity, not increased therapeutic effects.

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