Nursing Elites

1. A client is reviewing a medical record for advance directives. Which client statement indicates an understanding of the teaching?

• A. I don't need a living will because my family will make decisions.
• B. My living will takes effect only if I lose consciousness.
• C. My family will decide when to follow my living will.
• D. I can change my living will at any time.

Correct answer: D

Rationale: The correct answer is D because clients can change their living will at any time as long as they are mentally competent. Choice A is incorrect because relying solely on family to make decisions may not align with the client's wishes. Choice B is incorrect because a living will can address various situations, not just loss of consciousness. Choice C is incorrect because the client should be the primary decision-maker regarding their living will, not the family.

2. A healthcare professional is teaching a group of assistive personnel about the expected integumentary changes in older adults. Which change should the healthcare professional include?

• A. Increase in skin turgor
• B. Increase in subcutaneous fat
• C. Decrease in moisture levels
• D. Increase in oil production

Correct answer: C

Rationale: The correct answer is C: Decrease in moisture levels. In older adults, there is a reduction in oil production, leading to decreased moisture levels in the skin. This change can result in dry skin and increased risk of skin issues. The other choices are incorrect because in older adults, skin turgor tends to decrease, subcutaneous fat may decrease, and oil production typically decreases rather than increases.

3. A nurse is planning to administer several medications to a client through a nasogastric (NG) tube. What action should the nurse take?

• A. Dissolve crushed tablet medications in tap water
• B. Administer all medications together
• C. Flush the NG tube with 60 mL of water before each medication
• D. Dissolve medications separately and flush with sterile water

Correct answer: D

Rationale: The correct action for the nurse to take when administering medications through a nasogastric (NG) tube is to dissolve medications separately and flush the tube with sterile water. This is important to prevent interactions between medications and ensure accurate administration. Option A is incorrect because tap water may not be sterile and could lead to contamination. Option B is incorrect as it increases the risk of drug interactions and may affect the effectiveness of each medication. Option C is incorrect as 60 mL of water before each medication may not be enough to ensure proper medication delivery and prevent interactions.

4. A client with diabetes mellitus is being taught about foot care by a nurse. Which instruction should the nurse include?

• A. Cut toenails straight across
• B. Wear shoes at all times
• C. Apply lotion between the toes
• D. Soak feet in hot water daily

Correct answer: B

Rationale: The correct answer is to 'Wear shoes at all times.' This instruction is crucial for preventing foot injuries in clients with diabetes mellitus. Wearing shoes protects the feet from potential injuries and reduces the risk of developing foot ulcers. Cutting toenails straight across (not in a rounded shape) helps prevent ingrown toenails. Applying lotion between the toes can create a moist environment, increasing the risk of fungal infections. Soaking feet in hot water daily can lead to dry skin and potentially cause burns, which is not recommended for individuals with diabetes.

5. A nurse is providing discharge instructions to a client with a prescription for home oxygen therapy. What information should the nurse include?

• A. Use synthetic fabrics to avoid static electricity
• B. Turn off the oxygen when not in use
• C. Avoid open flames or smoking near oxygen
• D. Increase the oxygen flow rate as needed

Correct answer: C

Rationale: The correct answer is C: 'Avoid open flames or smoking near oxygen.' This information is crucial to prevent fires because oxygen supports combustion. Choices A, B, and D are incorrect. Choice A is not relevant to oxygen therapy. Choice B is incorrect as oxygen should not be turned off when in use as prescribed. Choice D is incorrect because adjusting the oxygen flow rate without healthcare provider guidance can be dangerous.

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