Nursing Elites

1. A client is receiving chemotherapy and is being taught about preventing infection. Which of the following instructions should the nurse include?

• A. Take your temperature daily.
• B. Avoid fresh fruits and vegetables.
• C. Limit your intake of high-protein foods.
• D. Increase your intake of high-fat foods.

Correct answer: B

Rationale: Clients receiving chemotherapy are instructed to avoid fresh fruits and vegetables to lower the risk of infection. Fresh produce may harbor bacteria or other pathogens that could be harmful to individuals with compromised immune systems. Taking the temperature daily may be important but is not directly related to preventing infection. Limiting high-protein foods is not necessary unless there are specific dietary restrictions due to the treatment plan. Increasing the intake of high-fat foods is not recommended during chemotherapy as a high-fat diet may lead to other health issues.

2. A nurse is providing teaching to a client who has osteoporosis about preventing fractures. Which of the following instructions should the nurse include?

• A. Increase your intake of calcium-rich foods.
• B. Avoid weight-bearing exercises.
• C. Perform weight-bearing exercises regularly.
• D. Avoid taking calcium supplements.

Correct answer: C

Rationale: The correct instruction the nurse should include is to perform weight-bearing exercises regularly. Weight-bearing exercises help maintain bone density and reduce the risk of fractures in clients with osteoporosis. Increasing intake of calcium-rich foods (Choice A) is also beneficial for bone health. Avoiding weight-bearing exercises (Choice B) is incorrect as these exercises are essential for strengthening bones. Avoiding calcium supplements (Choice D) may not be necessary if the client's dietary intake is inadequate.

3. A nurse is reviewing the laboratory values of a client who has liver cirrhosis. Which of the following findings should the nurse report to the provider?

• A. Bilirubin 0.8 mg/dL
• B. Ammonia 35 mcg/dL
• C. Prothrombin time 16 seconds
• D. Albumin 4 g/dL

Correct answer: C

Rationale: In clients with liver cirrhosis, an elevated prothrombin time indicates impaired liver function and decreased production of clotting factors. This finding should be reported to the provider for further evaluation and management. Choices A, B, and D are within normal ranges and do not specifically indicate worsening liver cirrhosis. Bilirubin 0.8 mg/dL is normal, ammonia 35 mcg/dL is within the reference range, and albumin 4 g/dL is also within the normal range for this client population.

4. A nurse is providing discharge teaching to a client who has a new prescription for nitroglycerin sublingual tablets. Which of the following statements should the nurse include?

• A. Take the medication with food to reduce stomach upset.
• B. Store the medication in a cool, dry place.
• C. Take one tablet every 5 minutes until the pain is relieved, up to three doses.
• D. This medication may cause drowsiness.

Correct answer: C

Rationale: The correct answer is to instruct the client to take one nitroglycerin sublingual tablet every 5 minutes until the pain is relieved, up to three doses. This dosing regimen is essential for managing angina attacks effectively. Choice A is incorrect because nitroglycerin sublingual tablets should be placed under the tongue for rapid absorption, not taken with food. Choice B is incorrect because nitroglycerin tablets should be stored in their original container at room temperature, away from moisture and heat. Choice D is incorrect because nitroglycerin typically does not cause drowsiness as a side effect.

5. A client is receiving discharge teaching for a new prescription of metformin. Which of the following client statements demonstrates an understanding of the teaching?

• A. I will take this medication with my meals.
• B. I will take this medication at the same time every day.
• C. I will avoid drinking alcohol while taking this medication.
• D. I will expect to experience weight gain while taking this medication.

Correct answer: C

Rationale: The correct answer is C because clients taking metformin should avoid alcohol as it increases the risk of lactic acidosis. Choices A, B, and D are incorrect. Choice A is not specific to metformin but rather a general recommendation for some medications. Choice B is a good practice for medication adherence but does not relate specifically to metformin. Choice D is inaccurate as weight gain is not an expected side effect of metformin.

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