Nursing Elites

1. A nurse is providing teaching about breastfeeding to a client who is postpartum. Which of the following instructions should the nurse include?

• A. Wash your nipples with soap after each feeding.
• B. Place your baby to your breast for 5 minutes every 4 hours.
• C. Ensure your newborn has at least six wet diapers per day.
• D. Give your newborn 30 mL of water between feedings.

Correct answer: C

Rationale: The correct answer is C: 'Ensure your newborn has at least six wet diapers per day.' Six or more wet diapers per day is an indicator that the newborn is receiving adequate breast milk, making this an important part of breastfeeding education. Choice A is incorrect because washing nipples with soap after each feeding can lead to dryness and cracking. Choice B is incorrect as babies should nurse on demand rather than on a strict schedule of 5 minutes every 4 hours. Choice D is incorrect as giving water to a newborn between feedings is not recommended and can interfere with breastfeeding.

2. A client has been prescribed raloxiphene. As the nurse, you know that raloxiphene is used to treat:

• A. Migraines
• B. Hypertension
• C. Osteoporosis
• D. Heart disease

Correct answer: C

Rationale: Raloxiphene (Evista) is a selective estrogen receptor modulator (SERM) used primarily to prevent and treat osteoporosis in postmenopausal women. It helps to maintain bone density and reduce the risk of fractures by mimicking the effects of estrogen on bone tissue. It is not indicated for the treatment of migraines, hypertension, or heart disease. Therefore, the correct answer is osteoporosis (Choice C). Choices A, B, and D are incorrect as raloxiphene is not used to treat migraines, hypertension, or heart disease.

3. A nurse is assessing a client for signs of anemia. Which of the following findings should the nurse look for?

• A. Increased energy
• B. Pale skin
• C. Elevated blood pressure
• D. Weight gain

Correct answer: B

Rationale: The correct answer is B: 'Pale skin.' Pale skin is a common sign of anemia due to reduced hemoglobin levels, which affects the skin color. Anemia is characterized by a decrease in the number of red blood cells or hemoglobin in the blood, leading to a paler complexion. Choices A, C, and D are incorrect. 'Increased energy' is not typically associated with anemia, as fatigue is a common symptom. 'Elevated blood pressure' is not a typical finding in anemia; instead, anemia may cause hypotension. 'Weight gain' is not a direct symptom of anemia; in fact, weight loss may occur in some cases due to reduced appetite or other factors associated with anemia.

4. A nurse is caring for a client prescribed ferrous sulfate for the treatment of anemia. Which of the following instructions should be included in client teaching about this medication?

• A. Take the medication on an empty stomach
• B. Notify your provider if your stool becomes dark green
• C. Decrease dietary fiber intake while taking this medication
• D. Take prescribed antacids at the same time as this medication

Correct answer: A

Rationale: The correct instruction for a client prescribed ferrous sulfate for anemia is to take the medication on an empty stomach. This is because ferrous sulfate is best absorbed in an acidic environment, which is enhanced on an empty stomach. However, if the client experiences gastrointestinal side effects, they can take the medication with food. Choice B, notifying the provider if stool becomes dark green, is correct because dark or black stools are common with iron therapy and not a cause for concern. Choice C, decreasing dietary fiber intake, is incorrect as dietary fiber does not interfere with the absorption of ferrous sulfate. Choice D, taking prescribed antacids at the same time, is incorrect as antacids can decrease the absorption of ferrous sulfate.

5. A nurse is educating a client about caloric intake and weight reduction. Which of the following client statements indicates an understanding of the teaching?

• A. If I eat 500 fewer calories per day, I should lose 1 pound per week.
• B. If I eat 450 fewer calories per day, I should lose 2 pounds per week.
• C. If I eat 250 fewer calories per day, I should lose 2 pounds per week.
• D. If I eat 300 fewer calories per day, I should lose 1 pound per week.

Correct answer: A

Rationale: The correct answer is A: 'If I eat 500 fewer calories per day, I should lose 1 pound per week.' This statement is accurate because a reduction of 500 calories per day typically results in a weight loss of 1 pound per week. This is based on the principle that a calorie deficit of 3,500 calories equals about 1 pound of body fat. Choices B, C, and D are incorrect because they do not align with the established relationship between calorie reduction and weight loss. Eating 450 fewer calories per day would not lead to a weight loss of 2 pounds per week; similarly, reducing calories by 250 or 300 per day would not result in losing 2 pounds or 1 pound per week, respectively.

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