Nursing Elites

1. A nurse is teaching a client with mild persistent asthma about montelukast. Which statement by the client indicates understanding?

• A. I will use this for asthma attacks.
• B. I should take this before exercise.
• C. This medication will decrease swelling and mucus production.
• D. I can stop this medication after 10 days.

Correct answer: C

Rationale: Montelukast is a leukotriene receptor antagonist that helps reduce swelling and mucus production in the airways, making it useful for long-term asthma management.

2. A nurse on a rehab unit is creating a plan of care for a newly admitted patient who has difficulty swallowing following a stroke. Which interprofessional team members should the nurse anticipate consulting?

• A. Physical therapist
• B. Speech-language pathologist
• C. Social worker
• D. Respiratory therapist

Correct answer: B

Rationale: The correct answer is B: Speech-language pathologist. A speech-language pathologist specializes in assessing and treating swallowing disorders, making them the most appropriate consultant for a patient with difficulty swallowing following a stroke. While other interprofessional team members such as a physical therapist (choice A), social worker (choice C), and respiratory therapist (choice D) may play important roles in the patient's care, the primary focus for swallowing difficulties would be the speech-language pathologist.

3. A nurse is caring for a client with Alzheimer's disease. Which action should the nurse include in the care plan to support the client’s cognitive function?

• A. Place a daily calendar in the kitchen
• B. Replace buttoned clothing with zippered items
• C. Replace carpet with hardwood floors
• D. Create variation in the daily routine

Correct answer: A

Rationale: Placing a daily calendar in the kitchen is beneficial for clients with Alzheimer's disease as it helps in orienting them to time and enhances cognitive function. This visual aid can assist in keeping track of days and activities. Choice B, replacing buttoned clothing with zippered items, is more related to promoting independence in dressing rather than directly supporting cognitive function. Choice C, replacing carpet with hardwood floors, focuses on safety and mobility rather than cognitive function. Choice D, creating variation in the daily routine, may be helpful for engagement and stimulation but does not directly address cognitive function as effectively as using a daily calendar.

4. A nurse is providing discharge teaching for a client who has COPD about nutrition. Which of the following instructions should the nurse include?

• A. Eat three large meals daily
• B. Consume high-calorie, high-protein foods
• C. Limit caffeinated drinks to two per day
• D. Drink fluids between meals

Correct answer: B

Rationale: The correct answer is B: 'Consume high-calorie, high-protein foods.' Clients with COPD often have increased energy needs due to the work of breathing. Consuming high-calorie, high-protein foods can help provide the necessary energy and prevent weight loss. Choice A is incorrect because eating three large meals daily may lead to increased shortness of breath due to a full stomach. Choice C is incorrect because limiting caffeinated drinks is important, but the recommendation should focus on reducing intake, not specifying a number. Choice D is incorrect because drinking fluids during mealtime can lead to early satiety, making it difficult for the client to consume enough calories.

5. A nurse is assessing a client diagnosed with schizophrenia. The nurse asks the client to interpret the following statement: “When the cat’s away, the mice will play.” The client responds, “The mice come out when the cat is not around.” The nurse should document this finding as:

• A. Echolalia
• B. Associative looseness
• C. Neologisms
• D. Concrete thinking

Correct answer: D

Rationale: The client’s literal interpretation of the statement is an example of concrete thinking, a cognitive symptom often seen in schizophrenia where abstract thinking is impaired. Choice A, Echolalia, is the repetition of words spoken by others, which is not demonstrated in this scenario. Choice B, Associative looseness, refers to a disturbance in the logical progression of thoughts, leading to a disorganized thought process. Choice C, Neologisms, involves creating new words or phrases with unique meanings, which is not evident in the client's response.

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