Nursing Elites

1. A client is reviewing information about advance directives with a nurse. Which of the following statements by the client indicates an understanding of the teaching?

• A. I understand that I can change my mind at any time.
• B. I have a living will that outlines my wishes when I am unable to make a decision.
• C. I need to inform my family about my wishes.
• D. I don’t need to worry about advance directives right now.

Correct answer: B

Rationale: The correct answer is B because having a living will indicates that the client understands and has documented their wishes regarding medical treatment when they are unable to make decisions. Choice A is incorrect because while it's true that clients can change their minds about advance directives, it doesn't specifically indicate an understanding of the teaching provided. Choice C is important but doesn't directly show if the client understands advance directives. Choice D is incorrect because it dismisses the importance of advance directives, indicating a lack of understanding.

2. A nurse is preparing to administer a pneumococcal vaccine. Which of the following should the nurse verify?

• A. Client's allergy to eggs
• B. Client's current medications
• C. Client's vaccination history
• D. Client's blood pressure

Correct answer: C

Rationale: The correct answer is C: Client's vaccination history. Before administering a pneumococcal vaccine, the nurse should verify the client's vaccination history to ensure they are due for the vaccine. Verifying the vaccination history helps prevent unnecessary vaccinations and ensures that the client receives the appropriate immunization at the right time. Choices A, B, and D are not directly related to the administration of the pneumococcal vaccine. Checking for allergies to eggs may be important for other vaccines, but it is not specifically relevant to pneumococcal vaccination. The client's current medications and blood pressure are important for general health assessment but are not directly related to verifying the need for a pneumococcal vaccine.

3. A charge nurse is making assignments for the upcoming shift. What assignment should the charge nurse give to an LPN?

• A. A client who requires complex medication management
• B. A client who has dehydration and inflammatory bowel disease (IBD)
• C. A client needing assessment of a new diagnosis
• D. A client requiring a nursing care plan update

Correct answer: B

Rationale: The correct assignment for an LPN would be a client who has dehydration and inflammatory bowel disease (IBD). This choice is appropriate because it involves monitoring the client's condition, providing basic care, and assisting with activities of daily living, which align with the scope of practice for LPNs. Choices A, C, and D involve tasks that are more complex and require a higher level of nursing education and training, making them less suitable for an LPN.

4. A healthcare provider is reviewing a prescription for doxazosin with a client. Which instruction should the healthcare provider provide?

• A. Decrease caloric intake to reduce weight gain
• B. Increase dietary fiber to prevent constipation
• C. Rise slowly when sitting up
• D. Take this medication each morning

Correct answer: C

Rationale: The correct instruction for a client prescribed with doxazosin is to rise slowly when sitting up. Doxazosin can cause orthostatic hypotension, leading to dizziness upon sudden position changes. Instructing the client to rise slowly helps prevent this side effect. Choices A, B, and D are incorrect because they are not directly related to the potential side effects or administration of doxazosin.

5. A client with a new ileostomy is receiving discharge instructions from a nurse. Which statement indicates the client understands the teaching?

• A. I will make sure my medications are enteric-coated.
• B. My stoma will drain liquid continuously.
• C. I will change my pouch system every two weeks.
• D. My stoma size will stay the same after it heals.

Correct answer: B

Rationale: The correct answer is B. Ileostomy stomas typically drain liquid continuously, unlike colostomies. This continuous drainage is a key characteristic that clients should understand postoperatively. Choice A is incorrect because ensuring medications are enteric-coated is not directly related to understanding ileostomy care. Choice C is incorrect as changing the pouch system every two weeks is not a general rule and may vary depending on the individual's needs. Choice D is incorrect because the stoma size can change during the healing process and clients should be informed about this possibility.

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