Nursing Elites

1. A client has a new prescription for metoprolol. Which of the following client statements indicates an understanding of the teaching?

• A. I will take this medication with a glass of milk.
• B. I will take my pulse before taking this medication.
• C. I will stop taking this medication if I experience nausea.
• D. I will take an antacid with this medication.

Correct answer: B

Rationale: The correct answer is B. Clients taking metoprolol should regularly check their pulse and should not take the medication if their pulse is too low. Option A is incorrect because metoprolol should not be taken with a glass of milk. Option C is incorrect because stopping medication abruptly can be harmful. Option D is incorrect because antacids should not be taken with metoprolol as they can decrease its absorption.

2. A nurse is caring for a client who has chronic kidney disease and reports nausea. The nurse should identify that this client is at risk for which of the following imbalances?

• A. Metabolic alkalosis
• B. Metabolic acidosis
• C. Respiratory alkalosis
• D. Respiratory acidosis

Correct answer: B

Rationale: The correct answer is B: Metabolic acidosis. Clients with chronic kidney disease are at risk for metabolic acidosis because the kidneys are unable to effectively excrete acids, leading to an accumulation of acid in the body. This metabolic imbalance can result in symptoms like nausea. Choices A, C, and D are incorrect. Metabolic alkalosis is not typically associated with chronic kidney disease. Respiratory alkalosis is more commonly seen in conditions such as hyperventilation. Respiratory acidosis, on the other hand, is often linked to conditions affecting the lungs or respiratory system, not primarily kidney disease.

3. A nurse is providing teaching to a client who has a new diagnosis of hypertension. Which of the following dietary recommendations should the nurse include?

• A. Limit sodium intake to 4 grams per day.
• B. Limit protein intake to 80 grams per day.
• C. Limit saturated fat intake to 7% of daily calories.
• D. Limit fluid intake to 1,500 mL per day.

Correct answer: C

Rationale: The correct answer is to limit saturated fat intake to 7% of daily calories. This recommendation is crucial for clients with hypertension to lower cholesterol levels and promote heart health. Choice A, limiting sodium intake to 4 grams per day, is important for hypertension but not the best recommendation compared to limiting saturated fats. Choice B, limiting protein intake to 80 grams per day, is not a primary dietary concern for hypertension. Choice D, limiting fluid intake to 1,500 mL per day, is not a standard recommendation for hypertension management.

4. A charge nurse is teaching a group of newly licensed nurses about the correct use of restraints. Which of the following should the nurse include in the teaching?

• A. Placing a belt restraint on a school-age child who has seizures.
• B. Securing wrist restraints to the bed rails for an adolescent.
• C. Applying elbow immobilizers to an infant receiving cleft lip injury.
• D. Keeping the side rails of a toddler's crib elevated.

Correct answer: D

Rationale: The correct answer is D. Keeping the side rails of a toddler's crib elevated is an appropriate use of restraints to prevent the child from falling, which is an essential safety measure. Placing a belt restraint on a school-age child with seizures (choice A) is not recommended as it can be dangerous during a seizure. Securing wrist restraints to the bed rails for an adolescent (choice B) may cause harm and should not be done routinely. Applying elbow immobilizers to an infant receiving a cleft lip injury (choice C) is not a standard practice for managing this condition and would not be appropriate.

5. A nurse is assessing a client who has chronic obstructive pulmonary disease (COPD). Which of the following findings should the nurse expect?

• A. Increased oxygen saturation with exercise.
• B. Pursed-lip breathing with exertion.
• C. Productive cough with clear sputum.
• D. Clubbing of the fingers.

Correct answer: C

Rationale: The correct answer is C: 'Productive cough with clear sputum.' Clients with COPD often have a chronic productive cough with thick, often purulent sputum. This sputum can be white, yellow, green, or clear. Choices A, B, and D are incorrect. Oxygen saturation may decrease with exertion in COPD due to impaired gas exchange. Pursed-lip breathing is used to control dyspnea, not directly related to increased saturation with exercise. Clubbing of the fingers is typically seen in conditions such as cyanotic heart disease or lung cancer.

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