Nursing Elites

1. A client who is 1 day postoperative following a total hip arthroplasty should be instructed to do which of the following?

• A. Avoid using a walker while walking.
• B. Keep the hip flexed at 90° while sitting.
• C. Place a pillow between your legs when turning.
• D. Cross your legs at the ankles when sitting.

Correct answer: C

Rationale: Placing a pillow between the legs is essential post-total hip arthroplasty to prevent adduction of the hip joint, reducing the risk of dislocation. Choices A, B, and D are incorrect. Using a walker while walking is encouraged for support and stability. Keeping the hip flexed at 90° while sitting can increase the risk of hip dislocation. Crossing legs at the ankles when sitting may also lead to hip dislocation.

2. A client who is to undergo surgery for a hip fracture is being taught by a nurse about postoperative pain management. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will ask for pain medication only if the pain becomes unbearable.
• B. I will ask the nurse to increase my medication if the pain doesn't subside.
• C. I will wait until the pain is severe before taking my medication.
• D. I will take my medication at regular intervals to stay ahead of the pain.

Correct answer: D

Rationale: The correct answer is D because taking pain medication at regular intervals helps maintain consistent pain control after surgery. Option A is incorrect because waiting for the pain to become unbearable can lead to inadequate pain management. Option B is incorrect as it suggests increasing medication without a schedule. Option C is incorrect because waiting for the pain to be severe before taking medication is not proactive pain management.

3. What intervention is key when managing a client with delirium?

• A. Administer antipsychotic medication to calm the client
• B. Identify any reversible causes of delirium
• C. Provide a low-stimulation environment
• D. Increase environmental stimulation

Correct answer: B

Rationale: The correct intervention when managing a client with delirium is to identify any reversible causes. Delirium can be caused by various factors such as infections, medications, dehydration, or metabolic imbalances. Administering antipsychotic medications (Choice A) may worsen delirium and should be avoided unless necessary for specific indications. Providing a low-stimulation environment (Choice C) is beneficial as it can help reduce agitation and confusion in individuals with delirium. Increasing environmental stimulation (Choice D) is contraindicated as it can exacerbate symptoms in delirious patients. Therefore, the priority should be on identifying and addressing reversible causes to effectively manage delirium.

4. A client receiving chemotherapy for cancer has developed stomatitis. Which of the following interventions should the nurse implement?

• A. Provide lemon-glycerin swabs
• B. Encourage the client to eat soft foods
• C. Avoid using toothpaste
• D. Instruct the client to use a mouthwash containing alcohol

Correct answer: B

Rationale: The correct intervention for a client with stomatitis, a common side effect of chemotherapy, is to encourage the client to eat soft foods. Soft foods help prevent further irritation to the mouth. Providing lemon-glycerin swabs (choice A) can be too harsh and irritating to the mouth. Avoiding toothpaste (choice C) is not necessary unless it contains harsh ingredients that can further irritate the mouth. Instructing the client to use a mouthwash containing alcohol (choice D) is contraindicated as alcohol-containing mouthwashes can be too harsh and drying for clients with stomatitis.

5. A healthcare professional is preparing to discharge a client who is immunocompromised. Which of the following vaccines should the professional plan to administer?

• A. Varicella
• B. Influenza
• C. Hepatitis B
• D. Pneumococcal polysaccharide

Correct answer: D

Rationale: Immunocompromised clients have weakened immune systems, making them more susceptible to infections. The pneumococcal polysaccharide vaccine is recommended for these individuals to help prevent pneumococcal infections, which can be severe and life-threatening. Varicella, Influenza, and Hepatitis B vaccines are not specifically indicated for immunocompromised clients. Varicella contains a live virus that can cause infections in immunocompromised individuals. Influenza is generally recommended for all individuals over 6 months of age but does not have the same priority as the pneumococcal vaccine for immunocompromised clients. Hepatitis B vaccine is crucial for preventing Hepatitis B infection but is not directly related to the increased infection risk faced by immunocompromised clients.

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