Nursing Elites

1. A healthcare professional is reviewing the laboratory findings of a client who has diabetes mellitus. Which of the following findings indicates a need to revise the client's plan of care?

• A. Serum sodium 144 mEq/L.
• B. HbA1c 10%.
• C. Random serum glucose 190 mg/dL.
• D. Creatinine 1.2 mg/dL.

Correct answer: C

Rationale: Elevated random serum glucose levels of 190 mg/dL indicate hyperglycemia and poor blood sugar control, requiring a revised plan of care. HbA1c levels above 7% also indicate long-term poor control of blood sugar. Serum sodium of 144 mEq/L and creatinine of 1.2 mg/dL are within normal ranges and do not directly indicate a need for a plan of care revision.

2. A nurse is providing discharge teaching to a client who has a new prescription for lithium. Which of the following instructions should the nurse include?

• A. Take this medication on an empty stomach.
• B. Avoid eating foods that contain tyramine.
• C. Drink at least 2 liters of water each day.
• D. Take this medication in the evening before bedtime.

Correct answer: C

Rationale: The correct instruction for a client prescribed lithium is to drink at least 2 liters of water each day. This is important to prevent dehydration and reduce the risk of lithium toxicity. Option A is incorrect because lithium is usually taken with food to minimize gastrointestinal side effects. Option B is unrelated to lithium and is more applicable to clients taking MAOIs. Option D is incorrect as lithium is typically taken in divided doses throughout the day to maintain therapeutic levels.

3. A client with a history of depression and experiencing a situational crisis is being assessed by a nurse. What action should the nurse take first?

• A. Notify the client's support system.
• B. Help the client identify personal strengths.
• C. Confirm the client's perception of the event.
• D. Teach the client relaxation techniques.

Correct answer: A

Rationale: When a client with a history of depression is experiencing a situational crisis, the first action the nurse should take is to notify the client's support system. This is crucial as the client may require immediate assistance and support. While helping the client identify personal strengths and confirming the client's perception of the event are important aspects of the assessment and intervention process, notifying the support system takes priority in ensuring the client's safety and well-being. Teaching relaxation techniques may be beneficial but addressing the client's immediate crisis through support system notification is the most appropriate initial action.

4. A client is receiving discharge teaching regarding a new prescription for amoxicillin. Which of the following client statements indicates an understanding of the teaching?

• A. I will take this medication until my symptoms are gone.
• B. I will take this medication until it is finished.
• C. I will take this medication on an empty stomach.
• D. I will take this medication with milk.

Correct answer: B

Rationale: The correct answer is B. It is crucial for clients to complete the entire course of antibiotics as prescribed, even if symptoms improve. This helps to ensure that the infection is fully treated and reduces the risk of developing antibiotic resistance. Choice A is incorrect because stopping the medication when symptoms disappear can lead to incomplete treatment. Choice C is incorrect as amoxicillin can be taken with or without food. Choice D is incorrect because taking amoxicillin with milk can decrease its absorption.

5. A nurse is providing teaching to a client who has a new prescription for ferrous sulfate. Which of the following instructions should the nurse include?

• A. Take this medication with orange juice to increase absorption.
• B. Take this medication on an empty stomach.
• C. Take this medication with milk if it causes stomach upset.
• D. Take this medication at bedtime.

Correct answer: A

Rationale: The correct instruction for a client prescribed ferrous sulfate is to take the medication with orange juice to enhance absorption. Orange juice is recommended because of its vitamin C content, which aids in the absorption of iron. Choice B, taking the medication on an empty stomach, is incorrect because ferrous sulfate is better absorbed with food. Choice C, taking the medication with milk if it causes stomach upset, is incorrect as calcium in milk can interfere with iron absorption. Choice D, taking the medication at bedtime, is incorrect as it is usually recommended to take iron supplements between meals or with food to enhance absorption.

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