Nursing Elites

1. A client is prescribed nicotine replacement therapy. Which statement should the nurse include in this client's teaching?

• A. Smoking while taking this medication will increase your risk of a stroke.
• B. Make a list of reasons why smoking is a bad habit.
• C. Stopping this medication suddenly increases your risk for a heart attack.
• D. Rise slowly when getting out of bed in the morning.

Correct answer: A

Rationale: When a client is prescribed nicotine replacement therapy, it is crucial to emphasize that smoking while using this therapy can increase the risk of a stroke. Smoking while on nicotine replacement therapy can lead to excessive nicotine levels in the body, elevating cardiovascular risks. Therefore, the nurse should educate the client on the importance of avoiding smoking while utilizing this medication. Choices B, C, and D are not relevant to the specific teaching required for a client on nicotine replacement therapy.

2. A client with a new tracheostomy is being seen in the oncology clinic. What finding by the nurse best indicates that goals for the nursing diagnosis Impaired Self-Esteem are being met?

• A. The client demonstrates a good understanding of stoma care.
• B. The client has joined a book club that meets at the library.
• C. Family members take turns assisting with stoma care.
• D. Skin around the stoma is intact without signs of infection.

Correct answer: B

Rationale: The client joining a book club that meets outside the home and requires him or her to go out in public is the best indicator that goals for Impaired Self-Esteem are being met. This social activity indicates an improvement in self-confidence and willingness to engage with others, which are essential aspects of self-esteem. The other choices, while positive, do not directly address self-esteem concerns related to social interaction and confidence.

3. A client with chronic obstructive pulmonary disease is being taught by a nurse about ways to facilitate eating. Which of the following statements indicates a need for further teaching?

• A. I will rest for at least 30 minutes before eating.
• B. I will take my bronchodilators after meals.
• C. I will eat five or six small meals each day.
• D. I will choose foods that are not gas-forming.

Correct answer: B

Rationale: Option B, 'I will take my bronchodilators after meals,' indicates a need for further teaching. Bronchodilators should be taken before meals to help open the airways and make breathing easier before eating. This statement suggests a misunderstanding of the timing for optimal bronchodilator effectiveness. Options A, C, and D are all appropriate strategies for facilitating eating for a client with chronic obstructive pulmonary disease.

4. A client with tuberculosis is starting combination drug therapy. Which of the following medications should the nurse NOT plan to administer?

• A. Rifampin
• B. Isoniazid
• C. Acyclovir
• D. Pyrazinamide

Correct answer: C

Rationale: Acyclovir is an antiviral medication used to treat herpes virus infections, not tuberculosis. Rifampin, Isoniazid, and Pyrazinamide are all commonly used in the treatment of tuberculosis. Therefore, the nurse should not plan to administer Acyclovir to a client with tuberculosis.

5. A client has a three-chamber closed chest tube system, and the water seal chamber rises with client inspiration. What action should the nurse take?

• A. Continue to monitor the client.
• B. Immediately notify the healthcare provider.
• C. Reposition the client to the left side.
• D. Clamp the chest tube near the water seal.

Correct answer: A

Rationale: In a client with a three-chamber closed chest tube system, a rise in the water seal chamber with client inspiration is an expected finding. The nurse should continue to monitor the client as this indicates that the system is functioning correctly. There is no need to notify the healthcare provider, reposition the client, or clamp the chest tube as these actions are not indicated in response to a rise in the water seal chamber.

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