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 is receiving continuous enteral feedings through a nasogastric tube. Which of the following findings should the nurse report to the provider?

• A. Gastric residual of 200 mL
• B. Heart rate of 100/min
• C. Urinary output of 250 mL in 12 hr
• D. Blood glucose level of 180 mg/dL

Correct answer: D

Rationale: The correct answer is D. A blood glucose level of 180 mg/dL is higher than expected and should be reported to prevent hyperglycemia complications. High blood glucose levels can lead to hyperglycemia, causing various issues such as increased risk of infection and delayed wound healing. Choices A, B, and C are within normal limits for a client receiving continuous enteral feedings and do not require immediate reporting.

3. A client is receiving radiation therapy for cancer. Which of the following skin care instructions should the nurse include in the teaching?

• A. Apply alcohol-free lotions to your skin to prevent dryness.
• B. Avoid exposing the irradiated area to direct sunlight.
• C. Cleanse the irradiated area with mild soap and water.
• D. Apply ice packs to the irradiated area to prevent swelling.

Correct answer: B

Rationale: The correct answer is to avoid exposing the irradiated area to direct sunlight. Direct sunlight can further damage the skin during radiation therapy. Choice A is incorrect because alcohol-based lotions can irritate the skin further. Choice C is incorrect because mild soap and water can be drying to the skin. Choice D is incorrect because applying ice packs can cause additional skin damage during radiation therapy.

4. A nurse is providing dietary teaching to a client with chronic kidney disease. Which of the following foods should the nurse recommend?

• A. Canned soup
• B. Bananas
• C. White bread
• D. Processed meats

Correct answer: C

Rationale: The correct answer is C: White bread. White bread is low in potassium, making it a suitable choice for clients with chronic kidney disease to prevent hyperkalemia. Canned soup (choice A), bananas (choice B), and processed meats (choice D) are high in potassium and should be limited or avoided by individuals with chronic kidney disease to manage their condition effectively.

5. A nurse is caring for a client who is 3 days postoperative following a bowel resection. Which of the following findings should the nurse report to the provider?

• A. Heart rate of 80/min
• B. White blood cell count of 9,000/mm3
• C. Temperature of 37.8°C (100°F)
• D. Blood pressure of 118/78 mm Hg

Correct answer: C

Rationale: A temperature of 37.8°C (100°F) should be reported to the provider as it can indicate infection, a common postoperative complication. A normal heart rate of 80/min (Choice A), white blood cell count of 9,000/mm3 (Choice B), and blood pressure of 118/78 mm Hg (Choice D) are within normal ranges and do not necessarily indicate a complication postoperatively.

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