Nursing Elites

1. A nurse is reviewing the prescription for doxazosin with a client. Which of the following should be included in the teaching?

• A. Decrease caloric intake to prevent weight gain.
• B. Increase dietary fiber to alleviate constipation.
• C. Rise slowly when sitting up from bed.
• D. Take this medication in the morning.

Correct answer: C

Rationale: The correct answer is C. Doxazosin can cause orthostatic hypotension, leading to dizziness and falls if the client rises quickly from a seated position. Instructing the client to rise slowly when sitting up from bed helps prevent these adverse effects. Choices A, B, and D are incorrect because doxazosin does not directly relate to caloric intake, dietary fiber, or a specific time of day for administration.

2. A nurse in a pediatric clinic is reviewing the laboratory test results of a school-age child. Which of the following findings should the nurse report to the provider?

• A. Hgb 12.5 g/dL.
• B. Platelets 250,000/mm³.
• C. Hct 40%.
• D. WBC 14,000/mm³.

Correct answer: D

Rationale: The correct answer is D. A WBC count of 14,000/mm³ is elevated, indicating a potential infection or inflammation, and should be reported to the provider for further evaluation and management. Choices A, B, and C are within normal ranges and do not require immediate reporting as they indicate normal hemoglobin, platelet count, and hematocrit levels for a school-age child.

3. A client who is postpartum requests information about contraception. Which of the following instructions should the nurse include?

• A. The lactation amenorrhea method is effective for the first year postpartum.
• B. You should not use the diaphragm used before your pregnancy.
• C. Apply the transdermal birth control patch on your upper arm.
• D. Avoid using vaginal spermicides while breastfeeding.

Correct answer: D

Rationale: The correct answer is to advise the client to avoid using vaginal spermicides while breastfeeding. This instruction is important as spermicides can potentially affect the milk supply and cause irritation. Choice A is incorrect because the effectiveness of the lactation amenorrhea method diminishes after the first six months postpartum. Choice B is incorrect as using the diaphragm used before pregnancy may not fit properly due to changes in the body postpartum. Choice C is incorrect as the transdermal birth control patch is typically applied to the abdomen, buttocks, or upper torso, not specifically the upper arm.

4. A client at 10 weeks of gestation with a history of UTIs is receiving teaching from a nurse. Which of the following statements should the nurse include?

• A. You should drink 240 ml (8 oz) of water before and after intercourse.
• B. You should avoid drinking orange juice because it increases the risk of infection.
• C. You should empty your bladder after intercourse to help prevent infection.
• D. You should take a hot bath to help prevent infection.

Correct answer: C

Rationale: The correct statement the nurse should include is to advise the client to empty their bladder after intercourse to help prevent UTIs. Emptying the bladder after intercourse helps reduce the risk of UTIs by flushing bacteria from the urethra. Choice A is incorrect as drinking water before and after intercourse is not specifically related to preventing UTIs. Choice B is incorrect as there is no direct correlation between orange juice consumption and UTI risk. Choice D is incorrect as taking a hot bath can actually increase the risk of UTIs by promoting bacterial growth.

5. A healthcare provider is preparing to administer an intramuscular injection to a client. Which of the following sites should the healthcare provider select?

• A. Deltoid
• B. Vastus lateralis
• C. Rectus femoris
• D. Dorsogluteal

Correct answer: B

Rationale: The vastus lateralis is the preferred site for intramuscular injections in adults due to its large muscle mass and low risk of complications. The deltoid, although a common site for vaccines, has a smaller muscle mass and may not be suitable for all types of medications. The rectus femoris is a muscle in the thigh that is more commonly used for intramuscular injections in infants. The dorsogluteal site is no longer recommended due to its proximity to major nerves and blood vessels.

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