Nursing Elites

1. A client with a new prescription for prednisone for the treatment of Addison's disease needs teaching. Which instruction should the nurse include?

• A. Take the medication with food
• B. Avoid taking aspirin
• C. Schedule a bone density test
• D. Expect increased appetite

Correct answer: C

Rationale: The correct instruction for the nurse to include is to schedule a bone density test. Prednisone can lead to reduced bone density, making regular monitoring crucial for clients on long-term therapy. Instructing the client to take the medication with food (choice A) or avoid taking aspirin (choice B) are not directly related to prednisone therapy for Addison's disease. While prednisone can cause increased appetite, it is not the priority instruction in this scenario, compared to monitoring bone density (choice D).

2. A nurse is preparing to apply a transdermal nicotine patch for a client. Which of the following actions should the nurse take?

• A. Shave hairy areas of skin prior to application.
• B. Wear gloves to apply the patch to the client's skin.
• C. Apply the patch within 1 hr of removing it from the protective pouch.
• D. Remove the previous patch and place it in a tissue.

Correct answer: B

Rationale: The correct answer is to wear gloves when applying the transdermal nicotine patch to prevent the nurse from absorbing nicotine through the skin. Choice A is incorrect because shaving hairy areas of skin is not necessary for applying a transdermal patch. Choice C is incorrect as transdermal patches should be applied immediately after removal from the protective pouch, not necessarily within 1 hour. Choice D is incorrect because the previous patch should be disposed of properly following institutional guidelines, not placed in a tissue.

3. Which of the following is a key consideration when providing wound care for a client with a pressure ulcer?

• A. Cover the wound with a dry, sterile dressing
• B. Perform a wound culture before applying ointment
• C. Cleanse the wound with alcohol
• D. Cover the wound with a wet-to-dry dressing

Correct answer: B

Rationale: Performing a wound culture before applying ointment is crucial when providing wound care for a client with a pressure ulcer. This step helps identify the presence of any infection, allowing for appropriate treatment. Choice A is incorrect because covering the wound with a dry, sterile dressing may not address potential infections. Choice C is incorrect as cleansing the wound with alcohol can be too harsh and drying to the surrounding skin. Choice D is incorrect because covering the wound with a wet-to-dry dressing is not typically recommended for pressure ulcers, as it can cause trauma to the wound bed during removal.

4. What is the most important action when providing wound care to a client with a pressure ulcer?

• A. Apply a dry, sterile dressing to the wound
• B. Cleanse the wound with normal saline
• C. Perform a wound culture before applying ointment
• D. Cover the wound with a wet-to-dry dressing

Correct answer: C

Rationale: Performing a wound culture before applying ointment is crucial when providing wound care to a client with a pressure ulcer. This action helps identify any underlying infections, allowing healthcare providers to select the most appropriate treatment. Options A, B, and D are not as critical as performing a wound culture, as they focus on wound dressing and cleansing rather than identifying potential infections.

5. A nurse manager is updating protocols for belt restraints. Which of the following guidelines should the nurse include?

• A. Document the client's condition every 15 minutes.
• B. Attach the restraints to a non-moving part of the bed.
• C. Avoid requesting a PRN restraint prescription for clients who are aggressive.
• D. Remove the client's restraints based on the client's condition.

Correct answer: A

Rationale: The correct answer is A: Document the client's condition every 15 minutes. When using belt restraints, it is crucial to document the client's condition regularly to ensure their safety and well-being. This guideline allows for ongoing assessment of the client's need for restraints and any potential adverse effects. Choice B is incorrect as restraints should not be attached to the bed frame but to a non-moving part of the bed to prevent harm in case of bed movement. Choice C is incorrect as PRN (as needed) restraint prescription should not be a routine practice and should only be considered after other interventions have been attempted. Choice D is incorrect as restraints should be removed and reevaluated based on the client's condition, not solely on a fixed time schedule.

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