Nursing Elites

1. An older adult client at risk for osteoporosis is being taught by a nurse about starting a regular physical activity program. Which type of activity should the nurse recommend?

• A. Walking briskly
• B. Riding a bicycle
• C. Performing isometric exercises
• D. Engaging in high-impact aerobics

Correct answer: A

Rationale: The correct answer is walking briskly. Weight-bearing exercises, such as brisk walking, are recommended for individuals at risk for osteoporosis because they help maintain bone mass and prevent bone loss. Riding a bicycle and performing isometric exercises are not weight-bearing activities, and therefore, may not provide the same bone-strengthening benefits as walking. High-impact aerobics can increase the risk of fractures in individuals with osteoporosis due to the high level of impact involved.

2. An 80-year-old client admitted with a diagnosis of a possible cerebral vascular accident has had a blood pressure ranging from 180/110 to 160/100 over the past 2 hours. The nurse has also noted increased lethargy. Which assessment finding should the nurse report immediately to the healthcare provider?

• A. Slurred speech
• B. Incontinence
• C. Muscle weakness
• D. Rapid pulse

Correct answer: A

Rationale: Slurred speech is a classic sign of a worsening stroke, suggesting a potential blockage or hemorrhage affecting speech centers in the brain. Prompt reporting of this symptom to the healthcare provider is crucial for immediate evaluation and intervention. While incontinence (Choice B) is important to monitor, it is not considered an immediate priority over slurred speech in this context. Muscle weakness (Choice C) and rapid pulse (Choice D) are also relevant in stroke assessment, but slurred speech takes precedence due to its strong association with neurological deficits in the setting of a possible cerebral vascular accident.

3. The nurse is providing discharge instructions to a client who has been prescribed an iron supplement. Which statement by the client indicates a need for further teaching?

• A. I should take the supplement with milk to increase absorption.
• B. I should expect my stools to turn black while taking this supplement.
• C. I should take the supplement with a full glass of water.
• D. I should take the supplement on an empty stomach.

Correct answer: A

Rationale: Taking an iron supplement with milk can decrease its absorption, indicating a need for further teaching.

4. The nurse is teaching an elderly client how to use MDIs (multi-dose inhalers). The nurse is concerned that the client is unable to coordinate the release of the medication with the inhalation phase. What is the nurse's best recommendation to improve the delivery of the medication?

• A. Nebulized treatments for home care
• B. Adding a spacer device to the MDI canister
• C. Asking a family member to assist the client with the MDI
• D. Requesting a visiting nurse to follow the client at home

Correct answer: B

Rationale: Adding a spacer device to the MDI canister is the best recommendation in this scenario. The spacer device helps to improve coordination and medication delivery by allowing the client more time to inhale the medication effectively. Nebulized treatments for home care (Choice A) involve a different delivery method and are not directly related to improving coordination with MDIs. Asking a family member to assist (Choice C) may not address the core issue of coordination between releasing the medication and inhalation. Requesting a visiting nurse (Choice D) may not be necessary if the client can improve coordination with the spacer device.

5. The nurse is planning care for a 12-year-old child with sickle cell disease in a vaso-occlusive crisis affecting the elbow. Which one of the following should be the priority?

• A. Limiting fluids
• B. Client-controlled analgesia
• C. Applying cold compresses to the elbow
• D. Performing passive range of motion exercises

Correct answer: B

Rationale: During a vaso-occlusive crisis in sickle cell disease, the priority intervention is effective pain management. Client-controlled analgesia allows the child to self-administer pain relief as needed, promoting comfort and reducing stress. Limiting fluids (choice A) is not appropriate in this scenario as hydration is essential to prevent complications. Cold compresses (choice C) may provide some comfort but do not address the underlying pain. Passive range of motion exercises (choice D) are contraindicated during a vaso-occlusive crisis due to the risk of further pain and tissue damage.

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