Nursing Elites

1. A client who is pregnant and has hyperemesis gravidarum is being taught about nutrition at home by a nurse. Which of the following statements indicate that the client understands the teachings?

• A. I will drink water with my meals.
• B. I will eat every 6 hours throughout the day.
• C. I will eat crackers before I get out of bed in the morning.
• D. I will limit my protein intake.

Correct answer: C

Rationale: The correct answer is C. Eating crackers before getting out of bed can help manage nausea associated with hyperemesis gravidarum. Choice A is incorrect because drinking water with meals may exacerbate nausea. Choice B is incorrect as eating every 6 hours may not be frequent enough to combat nausea and vomiting. Choice D is incorrect because protein intake should not be limited during pregnancy, especially in cases of hyperemesis gravidarum.

2. A client underwent coronary artery bypass grafting and is learning about following a low-cholesterol diet. Which of the following food choices indicates the client's understanding of these dietary instructions?

• A. Liver
• B. Milk
• C. Beans
• D. Eggs

Correct answer: C

Rationale: The correct answer is C: Beans. Beans are an excellent choice for individuals following a low-cholesterol diet post-coronary artery bypass grafting due to their low cholesterol content. Beans are high in fiber and protein, making them a heart-healthy option. Choice A, Liver, is high in cholesterol and should be avoided in a low-cholesterol diet. Choice B, Milk, contains cholesterol and saturated fats, which are not ideal for this diet. Choice D, Eggs, are also high in cholesterol and should be limited in a low-cholesterol diet.

3. An antibiotic IM injection for a 2-year-old child is ordered. The total volume of the injection equals 2.0 ml. The correct action is to

• A. administer the medication in 2 separate injections
• B. give the medication in the ventrogluteal site
• C. call to get a smaller volume ordered
• D. check with the pharmacy for a liquid form of the medication

Correct answer: A

Rationale: Administering the medication in 2 separate injections is the correct action. When the total volume of an injection is relatively large for a specific site, dividing it into smaller volumes and administering them separately is a safer practice to prevent discomfort, tissue damage, or absorption issues. Giving the medication in the ventrogluteal site can be appropriate for IM injections but does not address the issue of the total volume being too high for a single injection. Calling to get a smaller volume ordered may delay treatment and is not necessary when a safe administration method is available. Checking with the pharmacy for a liquid form of the medication does not directly address the issue of the total volume being too high for a single injection, and changing the formulation may not be necessary if the correct administration technique can be applied.

4. Which statement best describes the effects of immobility in children?

• A. Immobility prevents the progression of language and fine motor development
• B. Immobility in children has similar physical effects to those found in adults
• C. Children are more susceptible to the effects of immobility than adults are
• D. Children are likely to have prolonged immobility with subsequent complications

Correct answer: B

Rationale: The correct answer is B. Immobility in children indeed has physical effects similar to those found in adults. However, it can also significantly impact their development and growth. Choice A is incorrect because immobility does not solely prevent language and fine motor development but affects various aspects. Choice C is incorrect as susceptibility to the effects of immobility may vary between children and adults depending on individual factors. Choice D is incorrect as not all children are likely to have prolonged immobility with subsequent complications.

5. The healthcare provider is assessing a client who has just returned from surgery. Which of these findings requires the most immediate attention?

• A. Respiratory rate of 16 breaths per minute
• B. Blood pressure of 120/80 mm Hg
• C. Temperature of 99.5 degrees Fahrenheit
• D. Heart rate of 80 beats per minute

Correct answer: C

Rationale: A temperature of 99.5 degrees Fahrenheit is slightly elevated but not immediately critical. In a postoperative patient, an elevated temperature could indicate an infection, which requires prompt attention to prevent complications. The respiratory rate, blood pressure, and heart rate within normal ranges are important to monitor but do not indicate an immediate need for intervention as an elevated temperature does.

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