Nursing Elites

1. A 20-year-old obese female client is preparing to have gastric bypass surgery for weight loss. She says to the nurse, "I need this surgery because nothing else I have done has helped me to lose weight."? Which response by the nurse is most appropriate?

• A. "If you eat less, you can save some money."?
• B. "Exercise is a healthier way to lose weight."?
• C. "You should try the Atkins diet first."?
• D. "I respect your decision to choose surgery."?

Correct answer: D

Rationale: The most appropriate response by the nurse is to show respect and empathy towards the client's decision. Option D acknowledges the client's autonomy and decision-making process, fostering a therapeutic relationship. Options A, B, and C are insensitive and unprofessional. Option A implies a financial incentive for weight loss, which can be perceived as disrespectful and trivializing the client's concerns. Option B suggests an alternative method without considering the client's reasons for choosing surgery, potentially invalidating her experiences. Option C recommends a specific diet without addressing the client's concerns or choices, neglecting her autonomy in decision-making.

2. Teaching the client with gonorrhea how to prevent reinfection and further spread is an example of

• A. primary prevention
• B. secondary prevention
• C. tertiary prevention
• D. primary health care prevention

Correct answer: B

Rationale: The correct answer is B: secondary prevention. This type of prevention focuses on reducing the impact of a disease by early detection and treatment. In the case of gonorrhea, teaching the client how to prevent reinfection and further spread falls under secondary prevention because it aims to reduce the prevalence and morbidity of the disease. Choice A (primary prevention) involves measures to prevent the disease from occurring in the first place, such as vaccination. Choice C (tertiary prevention) focuses on managing the long-term consequences of a disease to prevent complications. Choice D (primary health care prevention) is not a recognized term in prevention strategies.

3. What could be a possible cause for the symptoms experienced by the client in Question 28?

• A. iron deficiency
• B. folate deficiency
• C. peptic ulcer
• D. iron overload

Correct answer: A

Rationale: Given the client's symptoms of fatigue, shortness of breath, and lightheadedness, along with her gender and fad dieting, the most likely cause is iron deficiency. Iron deficiency commonly presents with these symptoms due to decreased oxygen-carrying capacity in the blood. Folate deficiency would typically present with different symptoms such as mouth sores and changes in skin, not fitting the client's presentation. Peptic ulcer would manifest with abdominal pain, not primarily with the symptoms described. Iron overload would present with symptoms such as joint pain and fatigue, which are not consistent with the client's presentation.

4. A client with urinary tract calculi needs to avoid which of the following foods?

• A. lettuce
• B. cheese
• C. apples
• D. broccoli

Correct answer: B

Rationale: A client with urinary tract calculi needs to avoid foods high in calcium to prevent the formation of more stones. Cheese is high in calcium, so it should be avoided. Lettuce, apples, and broccoli are not typically associated with high calcium content and are safe options for individuals with urinary tract calculi. Therefore, the correct answer is cheese. Choices A, C, and D are not high in calcium and are safe for consumption by individuals with urinary tract calculi.

5. Clomiphene is prescribed for a female client to treat infertility. The nurse is providing information to the client and her spouse about the medication and provides the couple with which information?

• A. If the oral tablets are not successful, the medication will be administered intravenously.
• B. The couple should engage in coitus at least every other day during treatment.
• C. The physician should be notified immediately if breast engorgement occurs.
• D. Multiple births occur in a small percentage of clomiphene-facilitated pregnancies.

Correct answer: D

Rationale: The correct answer is that multiple births (usually twins) occur in a small percentage (8% - 10%) of clomiphene-facilitated pregnancies. The couple should be informed about this potential outcome. Clomiphene is available in 50-mg tablets for oral use; there is no intravenous form of the medication. Breast engorgement is a common side effect of clomiphene that typically resolves after discontinuation of the medication. Ovulation usually happens 5 to 10 days after the last dose of clomiphene, and the couple is advised to engage in coitus at least every other day during this time. Therefore, choices A, B, and C are incorrect as they do not provide accurate information regarding clomiphene treatment for infertility.

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