Nursing Elites

1. A nurse is teaching a client who has a new prescription for fluoxetine. Which of the following statements should the nurse include?

• A. "You should expect to feel an improvement in your symptoms within 1 week."
• B. "You may experience weight gain while taking this medication."
• C. "You should take this medication in the morning to prevent insomnia."
• D. "You should stop taking this medication if you experience dry mouth."

Correct answer: B

Rationale: The correct statement the nurse should include is that the client may experience weight gain while taking fluoxetine. Weight gain is a common side effect of fluoxetine, and patients should be informed about this potential issue. Stating that the client should expect improvement in symptoms within 1 week (Choice A) is incorrect as fluoxetine may take a few weeks to have a noticeable effect. Taking the medication in the morning to prevent insomnia (Choice C) is not necessary since fluoxetine can be taken at any time of the day. Instructing the client to stop taking the medication if experiencing dry mouth (Choice D) is misleading, as dry mouth is a common but usually not serious side effect of fluoxetine.

2. A nurse is assessing a client who has a history of angina and reports chest pain. Which of the following actions should the nurse take first?

• A. Administer oxygen at 2 L/min via nasal cannula.
• B. Obtain a 12-lead ECG.
• C. Administer nitroglycerin sublingually.
• D. Notify the provider.

Correct answer: B

Rationale: The correct answer is to obtain a 12-lead ECG. In a client with a history of angina and reporting chest pain, the priority action is to assess for myocardial infarction, which is best done through an ECG. Administering oxygen, nitroglycerin, or notifying the provider can be important actions but obtaining an ECG takes precedence in evaluating the client's condition.

3. What is the primary purpose of administering insulin to a patient with diabetes?

• A. Regulate blood glucose levels
• B. Increase metabolism
• C. Prevent complications
• D. Promote insulin sensitivity

Correct answer: A

Rationale: The correct answer is A: 'Regulate blood glucose levels.' Administering insulin to a patient with diabetes helps regulate blood glucose levels by facilitating the uptake of glucose into cells, thereby lowering high blood sugar levels. This process aims to prevent hyperglycemia and its associated complications. Choice B, 'Increase metabolism,' is incorrect as the primary role of insulin is not to increase metabolism directly. Choice C, 'Prevent complications,' is partially correct as regulating blood glucose through insulin administration does help prevent complications associated with uncontrolled diabetes, but it is not the primary purpose. Choice D, 'Promote insulin sensitivity,' is incorrect as insulin itself is administered to compensate for the lack of endogenous insulin in diabetic patients, rather than to promote sensitivity to it.

4. What is the best position for a patient experiencing shortness of breath?

• A. Supine position
• B. Semi-Fowler's position
• C. Trendelenburg position
• D. Prone position

Correct answer: B

Rationale: The best position for a patient experiencing shortness of breath is the Semi-Fowler's position. This position promotes lung expansion and improves oxygenation by allowing the chest to expand more fully. The Supine position (lying flat on the back) may worsen breathing difficulties by reducing lung capacity. The Trendelenburg position (feet elevated higher than the head) is not recommended for patients with shortness of breath as it can increase pressure on the diaphragm and compromise breathing. The Prone position (lying face down) is also not suitable for patients experiencing shortness of breath as it may further restrict breathing.

5. A nurse is planning care for a client who has tuberculosis. Which of the following actions should the nurse take to prevent the transmission of the disease?

• A. Place the client in droplet isolation.
• B. Place the client in airborne isolation.
• C. Wear a surgical mask when providing care to the client.
• D. Keep the client's door closed at all times.

Correct answer: B

Rationale: The correct answer is B: 'Place the client in airborne isolation.' Tuberculosis is an airborne disease transmitted through droplet nuclei. Placing the client in airborne isolation helps prevent the spread of the disease to others. Choice A, placing the client in droplet isolation, is incorrect because tuberculosis is not transmitted through large droplets. Choice C, wearing a surgical mask when providing care to the client, is not sufficient as airborne precautions are necessary. Choice D, keeping the client's door closed at all times, does not directly address the prevention of disease transmission in this case.

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