Nursing Elites

1. A client with heart failure and a new prescription for furosemide is receiving teaching from a nurse. Which of the following instructions should the nurse include?

• A. Avoid foods high in magnesium
• B. Take furosemide with food
• C. Eat foods that are rich in potassium
• D. Expect a decrease in blood pressure

Correct answer: C

Rationale: The correct instruction the nurse should include is to advise the client to eat foods that are rich in potassium. Furosemide is a loop diuretic that can cause the loss of potassium, leading to hypokalemia. Eating foods high in potassium can help prevent this electrolyte imbalance. Choice A is incorrect because furosemide does not directly interact with magnesium. Choice B is incorrect because furosemide is usually taken in the morning to prevent nighttime diuresis. Choice D is incorrect because furosemide is a diuretic that typically leads to a decrease in blood pressure rather than an increase.

2. A nurse is assessing a client who was brought to the psychiatric emergency services by law enforcement. The client has disorganized, incoherent speech with loose associations and religious content. The nurse should recognize these signs and symptoms as consistent with which of the following?

• A. Alzheimer's disease
• B. Schizophrenia
• C. Substance intoxication
• D. Depression

Correct answer: B

Rationale: The correct answer is B: Schizophrenia. Disorganized speech, loose associations, and religious delusions are characteristic symptoms of schizophrenia. In this scenario, the client's presentation aligns with positive symptoms of schizophrenia, indicating a severe mental disorder requiring immediate attention. Choice A, Alzheimer's disease, primarily involves cognitive decline and memory impairment, not disorganized speech or religious content. Choice C, Substance intoxication, may present with altered mental status but typically lacks the persistent pattern of symptoms seen in schizophrenia. Choice D, Depression, is associated with a different set of symptoms such as low mood, anhedonia, and changes in appetite or sleep, rather than disorganized speech and loose associations.

3. A client is found on the floor of their room experiencing a seizure. Which of the following actions is the priority for the nurse?

• A. Place the client on their side with their head forward
• B. Call for help
• C. Protect the client's head
• D. Restrain the client

Correct answer: A

Rationale: During a seizure, the priority action for the nurse is to place the client on their side with their head forward. This position helps maintain an open airway and prevents aspiration, which is crucial in managing the client's safety during a seizure. Calling for help is important but ensuring the client's immediate safety by positioning them correctly takes precedence. Protecting the client's head can be done concurrently while positioning the client. Restraint is not appropriate during a seizure as it can lead to injuries and complications.

4. A nurse is caring for a client receiving a dopamine infusion via a peripheral IV. Which of the following actions should the nurse take if the IV site appears infiltrated?

• A. Stop the infusion.
• B. Slow the infusion.
• C. Apply a warm compress to the site.
• D. Apply a cold compress to the site.

Correct answer: A

Rationale: Corrected Rationale: If infiltration is suspected, the nurse should immediately stop the dopamine infusion to prevent further damage to the surrounding tissue. Choice A is the correct answer because continuing the infusion can lead to tissue damage and compromise the client's care. Slowing the infusion (Choice B) is not sufficient to prevent harm and may still cause damage. Applying a warm compress (Choice C) or a cold compress (Choice D) is not the recommended action for infiltration; stopping the infusion is crucial to prevent complications.

5. A nurse is teaching a client about fecal occult blood testing (FOBT) for the screening of colorectal cancer. Which of the following statements should the nurse include in the teaching?

• A. “Your provider will use stool samples from your bowel movement to perform the test.”
• B. “Your provider will prescribe a stimulant laxative prior to the procedure to cleanse the bowel.”
• C. “You should begin biennial fecal occult blood testing for colorectal cancer screening at 50 years old.”
• D. “You should avoid taking corticosteroids prior to testing.”

Correct answer: D

Rationale: The correct answer is D. The nurse should instruct the client to avoid corticosteroids and vitamin C prior to testing to prevent false-positive results. Choice A is incorrect because stool samples from bowel movements, not from digital rectal examinations, are used for FOBT. Choice B is incorrect because a stimulant laxative is not typically prescribed before FOBT; rather, the client is instructed to follow specific dietary restrictions. Choice C is incorrect because biennial fecal occult blood testing for colorectal cancer screening usually begins at 50 years old, not 40.

Similar Questions