Nursing Elites

1. A client is being taught about taking warfarin to treat atrial fibrillation. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will take this medication on an empty stomach.
• B. If I forget to take a dose, I can take it later on the same day.
• C. I will skip my dose if I forget to take it.
• D. I can take an additional dose if I miss one.

Correct answer: B

Rationale: The correct answer is B because taking warfarin later on the same day if a dose is missed helps maintain therapeutic levels. Choice A is incorrect because warfarin should be taken with food to enhance absorption. Choice C is incorrect as skipping a dose can lead to fluctuations in warfarin levels. Choice D is incorrect as taking an additional dose can increase the risk of bleeding.

2. How should a healthcare professional assess and manage a patient with a tracheostomy?

• A. Monitor for signs of infection and ensure airway patency
• B. Suction airway secretions and provide humidified air
• C. Inspect stoma site and clean with saline
• D. Provide education on tracheostomy care

Correct answer: A

Rationale: Correct answer: Monitoring for signs of infection and ensuring airway patency is crucial in managing a patient with a tracheostomy. This involves observing for redness, swelling, or discharge at the stoma site, as well as assessing for any signs of respiratory distress. Choice B, suctioning airway secretions and providing humidified air, is important for maintaining airway hygiene but may not be the initial assessment priority. Choice C, inspecting the stoma site and cleaning with saline, is part of routine tracheostomy care but does not address immediate assessment and management needs. Choice D, providing education on tracheostomy care, is valuable but not the primary action required in the assessment and management of a patient with a tracheostomy.

3. A nurse is caring for a client who has hypokalemia. Which of the following clinical findings should the nurse expect?

• A. Hyperactive reflexes.
• B. Strong, bounding pulse.
• C. Decreased bowel sounds.
• D. Increased deep tendon reflexes.

Correct answer: C

Rationale: The correct answer is C: Decreased bowel sounds. In hypokalemia, decreased bowel sounds are common due to slowed peristalsis. Hyperactive reflexes (choice A) and increased deep tendon reflexes (choice D) are more indicative of hyperkalemia. A strong, bounding pulse (choice B) is not typically associated with hypokalemia.

4. A nurse at a long-term care facility is transcribing new prescriptions for four clients. Which of the following prescriptions is accurately transcribed by the nurse?

• A. KCl 10 mEq PO once daily
• B. KCl 20 mEq PO once daily
• C. Potassium gluconate PO
• D. Potassium chloride 20 mEq PO every morning

Correct answer: D

Rationale: The correct answer is D because it accurately transcribes the prescription by specifying the medication (Potassium chloride), the dose (20 mEq), the route (PO for by mouth), and the frequency (every morning). Choice A is incorrect as it specifies a lower dose compared to the correct prescription. Choice B is incorrect due to an inaccurate dose. Choice C is incorrect as it lacks specificity regarding the type of potassium prescribed and the dose.

5. A nurse is reinforcing teaching to a client with hypertension. What lifestyle change should be emphasized?

• A. Increase intake of sodium-rich foods
• B. Limit intake of high-fat foods
• C. Reduce intake of caffeinated beverages
• D. Eat high-protein foods to lower blood pressure

Correct answer: B

Rationale: The correct lifestyle change that should be emphasized for a client with hypertension is to limit the intake of high-fat foods. High-fat foods can contribute to high blood pressure, so reducing their consumption is important in managing hypertension. Choice A is incorrect because increasing intake of sodium-rich foods can worsen hypertension due to their effect on blood pressure. Choice C is incorrect as caffeinated beverages can also elevate blood pressure. Choice D is incorrect because while high-protein foods can be beneficial, they do not directly lower blood pressure like reducing high-fat foods would.

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