Nursing Elites

1. A client who is 1 day postpartum plans to breastfeed. Which statement indicates an understanding of the teaching provided by the nurse?

• A. I will breastfeed every 4 hours.
• B. I will feed my baby from each breast for 5 minutes.
• C. I will use both breasts at each feeding.
• D. I will pump my breasts if my baby does not wake up to feed.

Correct answer: C

Rationale: The correct answer is C. Using both breasts at each feeding helps ensure adequate milk production and consumption. Option A is incorrect because breastfeeding should be done on demand rather than following a strict schedule. Option B is incorrect as limiting feeding time to 5 minutes per breast may not provide the baby with enough milk. Option D is also incorrect as pumping should not replace direct breastfeeding unless there is a specific medical reason to do so.

2. When discussing clients designating a health care proxy in situations requiring a durable power of attorney for health care (DPAHC), what information should the charge nurse include?

• A. The proxy should make health care decisions for the client regardless of the client's ability to do so.
• B. The proxy can make financial decisions if the need arises.
• C. The proxy can make treatment decisions if the client is under anesthesia.
• D. The proxy should manage legal issues for the client.

Correct answer: C

Rationale: The correct answer is C. The charge nurse should include information that the proxy can make treatment decisions if the client is under anesthesia. This is a key function of a durable power of attorney for health care. Choices A, B, and D are incorrect because a health care proxy's role is specifically related to making health care decisions, not financial decisions, legal issues, or decisions made under anesthesia.

3. A client with asthma asks how to use a peak flow meter. Which of the following instructions should the nurse provide?

• A. Use the peak flow meter at the same time each day.
• B. Take a slow, deep breath and blow out as hard as you can.
• C. Keep a log of your peak flow readings.
• D. Perform the test before using any bronchodilators.

Correct answer: D

Rationale: The correct answer is to instruct the client to perform the peak flow test before using any bronchodilators. This is important because it provides the most accurate baseline measurement of lung function. Choice A is not necessarily crucial for the accuracy of the test. Choice B describes the technique for spirometry, not peak flow meter use. Choice C, while important for tracking trends, is not directly related to the accuracy of the initial measurement.

4. A nurse is caring for a toddler who has acute lymphocytic leukemia. In which of the following activities should the toddler participate?

• A. Looking at alphabet flashcards
• B. Playing with a large plastic truck
• C. Using scissors to cut out paper shapes
• D. Watching a cartoon in the dayroom

Correct answer: B

Rationale: The correct answer is playing with a large plastic truck. This activity is suitable for toddlers as it promotes their development, encourages fine motor skills, and provides an opportunity for imaginative play. Looking at alphabet flashcards may be more suitable for older children who are learning letters and words. Using scissors to cut out paper shapes may pose a safety risk for a toddler, as they may not have the dexterity or understanding required for this activity. Watching a cartoon in the dayroom is a passive activity and does not actively engage the toddler in physical or cognitive development.

5. A nurse is reviewing laboratory data for a client who has chronic kidney disease. Which of the following findings should the nurse expect?

• A. Increased creatinine
• B. Increased hemoglobin
• C. Increased bicarbonate
• D. Increased calcium

Correct answer: A

Rationale: The correct answer is A: Increased creatinine. In chronic kidney disease, the kidneys are unable to filter waste effectively, leading to a buildup of creatinine in the blood. This results in increased creatinine levels in laboratory tests. Choice B, increased hemoglobin, is not typically associated with chronic kidney disease. Choice C, increased bicarbonate, is also not a common finding in chronic kidney disease; in fact, metabolic acidosis with decreased bicarbonate levels is more common. Choice D, increased calcium, is not expected in chronic kidney disease; instead, calcium levels may be low due to impaired kidney function.

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