Nursing Elites

1. A client at risk for osteoporosis is receiving teaching from a nurse. Which of the following client statements indicates an understanding of the teaching?

• A. I will avoid weight-bearing exercises.
• B. I should increase my intake of vitamin D.
• C. I should reduce my intake of dairy products.
• D. I will increase my intake of foods high in calcium.

Correct answer: B

Rationale: The correct answer is B: 'I should increase my intake of vitamin D.' Adequate vitamin D intake is crucial for calcium absorption, which is essential for bone health and preventing osteoporosis. Avoiding weight-bearing exercises (choice A) would be detrimental as weight-bearing activities help improve bone density. Reducing dairy intake (choice C) is not recommended as dairy products are a good source of calcium. While increasing calcium intake (choice D) is important, ensuring sufficient vitamin D levels for proper absorption is equally crucial for bone health.

2. A nurse is providing teaching to a client who has a new prescription for clopidogrel. Which of the following instructions should the nurse include?

• A. Avoid eating foods high in potassium.
• B. Avoid drinking alcohol while taking this medication.
• C. Take this medication with a full glass of water.
• D. Take this medication with a full glass of water.

Correct answer: C

Rationale: The correct answer is C. Clients taking clopidogrel should take the medication with a full glass of water to prevent gastrointestinal irritation. Choice A is incorrect because there is no specific recommendation to avoid foods high in potassium with clopidogrel. Choice B is unrelated to the medication's administration. Choice D is a duplication of choice C, providing no additional information.

3. A nurse is caring for a client who is receiving oxytocin IV for augmentation of labor. The client's contractions are occurring every 45 seconds with a nine-second duration, and the fetal heart rate is 170 to 180 beats per minute. Which of the following actions should the nurse take?

• A. Discontinue oxytocin infusion
• B. Increase oxytocin infusion
• C. Decrease oxytocin infusion
• D. Maintain oxytocin infusion

Correct answer: A

Rationale: In this scenario, the client is experiencing frequent contractions with a short duration and an elevated fetal heart rate, indicating potential fetal distress. Discontinuing the oxytocin infusion is crucial to prevent further complications and restore normal fetal parameters. Increasing or maintaining the oxytocin infusion could exacerbate the situation, leading to more distress for the fetus. Decreasing the oxytocin infusion may not be sufficient to address the current issue and could delay the improvement of fetal well-being.

4. A client is receiving discharge teaching regarding a new prescription for warfarin. Which of the following statements by the client indicates a need for further teaching?

• A. I will eat more leafy green vegetables while taking warfarin.
• B. I will have my INR checked regularly while taking warfarin.
• C. I will avoid drinking grapefruit juice while taking warfarin.
• D. I will use a soft toothbrush while taking warfarin.

Correct answer: A

Rationale: The correct answer is A. Clients taking warfarin should avoid leafy green vegetables as they are high in vitamin K, which can reduce the effectiveness of the medication. Therefore, the statement 'I will eat more leafy green vegetables while taking warfarin' indicates a need for further teaching. Choice B is correct as regular monitoring of INR levels is necessary for clients on warfarin. Choice C is correct as grapefruit juice can interact with warfarin and should be avoided. Choice D is correct as using a soft toothbrush is recommended to prevent gum bleeding while on warfarin.

5. A client has a new prescription for furosemide. Which of the following statements should the nurse include in the teaching?

• A. This medication will increase your potassium levels.
• B. You should take this medication with food to prevent gastrointestinal upset.
• C. This medication will decrease your blood glucose levels.
• D. You should increase your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct statement the nurse should include in the teaching for a client with a new prescription for furosemide is that the client should take the medication with food to prevent gastrointestinal upset. Furosemide is a loop diuretic that can cause gastrointestinal upset, so taking it with food can help reduce this side effect and improve medication tolerance. Choices A, C, and D are incorrect because furosemide does not increase potassium levels, decrease blood glucose levels, or require an increase in the intake of potassium-rich foods. Therefore, the most important teaching point for the client is to take furosemide with food.

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