Nursing Elites

1. A nursing student asks what essential hypertension is. What response by the registered nurse is best?

• A. It means it is caused by another disease.
• B. It means it is essential that it be treated.
• C. It is hypertension with no specific cause.
• D. It refers to severe and life-threatening hypertension.

Correct answer: C

Rationale: Essential hypertension, also known as primary or idiopathic hypertension, is the most common type of hypertension. It has no specific underlying cause such as an associated disease process. In contrast, hypertension that is due to another disease is referred to as secondary hypertension. Malignant hypertension is a severe and life-threatening form of hypertension characterized by rapidly progressive blood pressure elevation and potential end-organ damage.

2. A nurse is evaluating a 3-day diet history with a client who has an elevated lipid panel. What meal selection indicates the client is managing this condition well with diet?

• A. A 4-ounce steak, French fries, iceberg lettuce
• B. Baked chicken breast, broccoli, tomatoes
• C. Fried catfish, cornbread, peas
• D. Spaghetti with meat sauce, garlic bread

Correct answer: B

Rationale: The diet recommended for this client would be low in saturated fats & red meat, high in vegetables & whole grains (fiber), low in salt, & low in trans-fat. The best choice is the chicken with broccoli & tomatoes. The French fries have too much fat & the iceberg lettuce has little fiber. The catfish is fried. The spaghetti dinner has too much red meat & no vegetables.

3. A client had a total hip arthroplasty. Which of the following prescriptions should the nurse verify with the provider?

• A. Administer enoxaparin 30 mg subcutaneously every 12 hr
• B. Place a wedge or pillow between the client's legs when turning.
• C. Instruct the client to restrict flexion of the hip past 120�.
• D. Encourage the client to perform foot and calf exercises every 2 hr

Correct answer: C

Rationale: Following a total hip arthroplasty, the client should be instructed to restrict hip flexion past 90 degrees to prevent dislocation of the prosthesis. Restricting flexion past 120 degrees is excessive and could lead to complications. Therefore, the nurse should verify this prescription with the provider to ensure the client's safety and proper postoperative care.

4. When caring for a client with Alzheimer's disease, what is the most appropriate communication technique for a nurse to use?

• A. Providing detailed explanations
• B. Speaking in a loud and clear voice
• C. Using simple and direct statements
• D. Offering multiple choices to the client

Correct answer: C

Rationale: When communicating with clients with Alzheimer's disease, using simple and direct statements is the most appropriate technique. This approach helps to minimize confusion, enhance understanding, and facilitate effective communication with individuals who may have difficulty processing complex information due to their condition.

5. A client had an evacuation of a subdural hematoma. Which of the following actions should the nurse take first?

• A. Observe for cerebrospinal fluid (CSF) leaks from the evacuation site.
• B. Assess for an increase in temperature.
• C. Check the oximeter.
• D. Monitor for manifestations of increased intracranial pressure.

Correct answer: C

Rationale: When caring for a client who had an evacuation of a subdural hematoma, the nurse's priority is to check the oximeter. Monitoring oxygen saturation is crucial to ensure adequate tissue oxygenation, especially after such a procedure. This assessment helps in early detection of hypoxemia, which can be detrimental to the client's recovery. While observing for CSF leaks, assessing for temperature changes, and monitoring for signs of increased intracranial pressure are important, checking the oximeter takes precedence to address immediate oxygenation needs.

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