Nursing Elites

1. A nurse is reviewing the medical history of a client who has angina. What risk factor should the nurse identify?

• A. Hyperlipidemia.
• B. COPD.
• C. Seizure disorder.
• D. Hyponatremia.

Correct answer: A

Rationale: The correct answer is A, Hyperlipidemia. Hyperlipidemia, characterized by high levels of lipids in the blood, is a well-established risk factor for the development of angina. Elevated lipid levels can lead to atherosclerosis, which narrows the arteries supplying the heart muscle with oxygenated blood, increasing the risk of angina. Choices B, C, and D are incorrect because COPD, seizure disorder, and hyponatremia are not directly associated with an increased risk of angina.

2. A client who is postoperative following hip replacement surgery. Which of the following actions should the nurse take to prevent dislocation of the hip?

• A. Position the client's legs in adduction
• B. Place a pillow between the client's legs when turning
• C. Keep the client in a low Fowler's position
• D. Turn the client onto the affected side

Correct answer: B

Rationale: Placing a pillow between the client's legs when turning is essential to prevent hip dislocation post hip replacement surgery. This action helps maintain proper alignment of the hip joint and prevents adduction, which can lead to dislocation. Positioning the client's legs in adduction (choice A) can increase the risk of hip dislocation. Keeping the client in a low Fowler's position (choice C) or turning the client onto the affected side (choice D) does not directly address hip dislocation prevention.

3. A client with a new diagnosis of type 1 diabetes mellitus is being taught by a nurse about insulin administration. Which of the following instructions should the nurse include?

• A. Store unopened vials of insulin in the refrigerator, not the freezer.
• B. Rotate injection sites within the same region to prevent tissue damage.
• C. Administer insulin at a 90-degree angle for subcutaneous injections.
• D. Avoid massaging the injection site after administering insulin.

Correct answer: B

Rationale: The correct answer is to rotate injection sites within the same region to prevent tissue damage. By rotating sites, the client can prevent lipodystrophy, which is a condition characterized by the loss or change in body fat at the site of repeated injections. This practice also helps to ensure proper insulin absorption. Storing unopened vials of insulin in the refrigerator (Choice A) is correct, not in the freezer, as freezing can damage the insulin. Administering insulin at a 90-degree angle (Choice C) is more appropriate for subcutaneous injections, while a 45-degree angle is used for intramuscular injections. Massaging the injection site after administering insulin (Choice D) is not recommended as it can affect insulin absorption rates.

4. A client has a new prescription for alendronate. Which of the following instructions should the nurse include?

• A. Take this medication at bedtime.
• B. Take this medication with food to reduce stomach upset.
• C. Remain upright for 30 minutes after taking this medication.
• D. Chew the medication for faster absorption.

Correct answer: C

Rationale: The correct instruction when taking alendronate is to remain upright for 30 minutes after administration. This helps prevent esophageal irritation, a known side effect of the medication. Option A is incorrect because alendronate should be taken in the morning on an empty stomach. Option B is incorrect as taking alendronate with food decreases its absorption. Option D is incorrect as alendronate should be swallowed whole with a full glass of water and not chewed.

5. What is the best dietary recommendation for a patient with chronic kidney disease?

• A. Low-protein diet
• B. High-protein diet
• C. Low-sodium diet
• D. High-sodium diet

Correct answer: C

Rationale: The correct answer is a low-sodium diet. Patients with chronic kidney disease are often advised to follow a low-sodium diet to help manage fluid retention. Excessive sodium intake can lead to fluid buildup in the body, causing complications for individuals with kidney issues. Choices A and B are incorrect because while protein intake may need to be monitored in kidney disease, the primary focus is typically on sodium restriction. Choice D is incorrect as a high-sodium diet would exacerbate fluid retention in patients with chronic kidney disease.

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