Nursing Elites

1. A client has a new diagnosis of hypertension and is being taught about lifestyle changes by a nurse. Which of the following instructions should the nurse include?

• A. Increase your sodium intake to 3,000 mg per day.
• B. Exercise for 30 minutes at least 5 days a week.
• C. Sleep for at least 10 hours each night.
• D. Limit your fluid intake to 1 liter per day.

Correct answer: B

Rationale: The correct answer is B: "Exercise for 30 minutes at least 5 days a week." Regular exercise helps promote cardiovascular health and manage hypertension. Choice A is incorrect because increasing sodium intake is not recommended for hypertension. Choice C is incorrect because while sleep is important, excessive sleep duration is not typically part of hypertension management. Choice D is incorrect because fluid intake should be adequate unless advised otherwise by a healthcare provider.

2. During an in-service about nursing leadership, what information should the nurse include about an effective leader?

• A. Acts as an advocate for the nursing unit.
• B. Prioritizes staff requests over client needs.
• C. Shares personal opinions to influence the group's values.
• D. Provides routine client care and documentation.

Correct answer: A

Rationale: An effective leader advocates for the unit's success and its members. Choice B is incorrect because prioritizing staff requests over client needs does not align with effective leadership, which should focus on client-centered care. Choice C is incorrect as sharing personal opinions to influence the group's values can be biased and may not reflect the best interest of the team. Choice D is incorrect because while providing client care is essential, effective leadership involves more than routine tasks and includes guiding and supporting the team.

3. A client is postoperative following cataract surgery. Which of the following instructions should the nurse include?

• A. Avoid lying flat for 24 hours after surgery.
• B. Avoid bending at the waist.
• C. Wear an eye patch at night for 1 week.
• D. Sleep on your affected side to reduce discomfort.

Correct answer: B

Rationale: The correct instruction that the nurse should include for a client postoperative following cataract surgery is to avoid bending at the waist. Bending at the waist can increase intraocular pressure, which is not recommended after cataract surgery. Choices A, C, and D are incorrect because lying flat for 24 hours after surgery may not be necessary, wearing an eye patch at night for a week is not a standard postoperative instruction for cataract surgery, and sleeping on the affected side may not necessarily reduce discomfort and can increase pressure on the eye.

4. Which electrolyte imbalance is most concerning for a patient on loop diuretics?

• A. Hypokalemia
• B. Hyponatremia
• C. Hyperkalemia
• D. Hypercalcemia

Correct answer: A

Rationale: The correct answer is hypokalemia. Loop diuretics can cause potassium depletion leading to hypokalemia, which is particularly concerning as it can result in cardiac arrhythmias. Hyponatremia (choice B) is not typically associated with loop diuretics. Hyperkalemia (choice C) is less common in patients on loop diuretics. Hypercalcemia (choice D) is not a typical electrolyte imbalance associated with loop diuretics.

5. A nurse is caring for a client who has chronic obstructive pulmonary disease (COPD). Which of the following findings should the nurse report to the provider?

• A. Oxygen saturation of 92%
• B. Use of pursed-lip breathing
• C. Increased anterior-posterior chest diameter
• D. Productive cough with green sputum

Correct answer: D

Rationale: The correct answer is D. A productive cough with green sputum can indicate a bacterial infection, which is a concern for clients with COPD. Reporting this finding to the provider is important for further evaluation and management. Choices A, B, and C are not as concerning in the context of COPD management. An oxygen saturation of 92% is within an acceptable range for COPD patients, pursed-lip breathing is a helpful technique for managing breathing difficulties in COPD, and an increased anterior-posterior chest diameter is a common finding in clients with COPD due to chronic air trapping.

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