Nursing Elites

1. A nurse is teaching a client who has peripheral arterial disease (PAD) about exercise recommendations. Which of the following instructions should the nurse include?

• A. Exercise to the point of pain
• B. Stop exercising if pain occurs
• C. Exercise only once per week
• D. Avoid walking to prevent pain

Correct answer: B

Rationale: The correct instruction the nurse should include is to 'Stop exercising if pain occurs.' In peripheral arterial disease (PAD), it is crucial to avoid exercising to the point of pain as this may worsen the condition and lead to complications. Exercising to the point of pain can result in inadequate blood flow to the extremities, causing further damage. By stopping exercise if pain occurs, the client can prevent exacerbating their condition. Choices A, C, and D are incorrect because exercising to the point of pain, limiting exercise to once per week, and avoiding walking altogether are not recommended strategies for managing PAD and could potentially harm the client.

2. What are the risk factors for deep vein thrombosis (DVT) and how can it be prevented?

• A. Immobility and oral contraceptive use
• B. Pregnancy and smoking
• C. Obesity and varicose veins
• D. Hypertension and high cholesterol

Correct answer: A

Rationale: The correct answer is A: Immobility and oral contraceptive use. Immobility and oral contraceptive use are significant risk factors for deep vein thrombosis (DVT). Immobility leads to blood stasis, increasing the risk of clot formation, while oral contraceptive use can promote hypercoagulability. Prevention strategies for DVT include promoting mobility to enhance blood circulation and using anticoagulants to prevent clot formation. Choices B, C, and D are incorrect. While pregnancy and smoking can increase the risk of DVT, they are not the specific factors mentioned in the question. Similarly, obesity and varicose veins, as well as hypertension and high cholesterol, are not the primary risk factors associated with DVT.

3. A nurse is providing dietary teaching for a client with chronic kidney disease. What should be emphasized?

• A. Increase protein intake to promote healing
• B. Limit intake of potassium and phosphorus
• C. Increase fluid intake to prevent dehydration
• D. Encourage the intake of high-sodium foods

Correct answer: B

Rationale: The correct answer is to emphasize limiting the intake of potassium and phosphorus for a client with chronic kidney disease. Excessive intake of potassium and phosphorus can lead to complications in kidney disease patients. Choice A is incorrect because increasing protein intake can put additional stress on the kidneys. Choice C is incorrect as excessive fluid intake can worsen kidney function in such clients. Choice D is incorrect as encouraging high-sodium foods can lead to fluid retention and hypertension, which are not beneficial for individuals with chronic kidney disease.

4. A nurse in a long-term care facility is auscultating the lung sounds of a client who reports shortness of breath and increased fatigue. The nurse should report which of the following to the provider after hearing this sound?

• A. Fine crackles
• B. Rhonchi
• C. Wheezing
• D. Stridor

Correct answer: A

Rationale: The correct answer is A: Fine crackles. Fine crackles suggest fluid in the lungs, which could indicate a serious respiratory issue like pulmonary edema. This sound should be reported to the provider for further evaluation and possible intervention. Rhonchi (choice B) are low-pitched wheezing sounds often caused by secretions in the larger airways, wheezing (choice C) is a high-pitched whistling sound usually caused by narrowed airways, and stridor (choice D) is a high-pitched sound heard on inspiration that indicates upper airway obstruction. While these sounds also require attention, fine crackles are more indicative of fluid accumulation in the lungs, making them the priority for reporting in this scenario.

5. A nurse is providing discharge instructions to a client with oxygen therapy. What should the nurse emphasize?

• A. Avoid keeping oxygen tanks in an upright position
• B. Keep oxygen equipment at least 6 feet away from heat sources
• C. Allow family members to smoke in designated areas
• D. Restrict fluid intake while using oxygen therapy

Correct answer: B

Rationale: The correct answer is B: 'Keep oxygen equipment at least 6 feet away from heat sources.' It is crucial to keep oxygen equipment away from heat sources to prevent fire hazards. Option A is incorrect as oxygen tanks should be stored in an upright position. Option C is wrong because smoking near oxygen equipment poses a significant fire risk. Option D is also incorrect as fluid intake should not be restricted while using oxygen therapy; in fact, it is important to maintain adequate hydration.

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