Nursing Elites

1. An 80-year-old client is given morphine sulfate for postoperative pain. Which concomitant medication should the nurse question that poses a potential development of urinary retention in this geriatric client?

• A. Nonsteroidal anti-inflammatory agents.
• B. Antihistamines.
• C. Tricyclic antidepressants.
• D. Antibiotics.

Correct answer: C

Rationale: The correct answer is C: Tricyclic antidepressants. Drugs with anticholinergic properties, such as tricyclic antidepressants, can exacerbate urinary retention associated with opioids in older clients. Nonsteroidal anti-inflammatory agents (Choice A) do not typically cause urinary retention. Antihistamines (Choice B) may cause urinary retention but are not the primary concern in this scenario. Antibiotics (Choice D) are not associated with an increased risk of urinary retention compared to tricyclic antidepressants.

2. The nurse is preparing a teaching plan for a client who is newly diagnosed with hypothyroidism. Which instruction should the nurse include?

• A. Take levothyroxine (Synthroid) at bedtime.
• B. Increase fiber intake to prevent constipation.
• C. Take the medication on an empty stomach.
• D. Take a double dose if a dose is missed.

Correct answer: C

Rationale: The correct instruction for a client newly diagnosed with hypothyroidism is to take the medication on an empty stomach. This is important because taking levothyroxine on an empty stomach ensures better absorption of the medication. Choice A, taking levothyroxine at bedtime, is incorrect as it does not promote optimal absorption. Choice B, increasing fiber intake to prevent constipation, is important but not the priority when it comes to medication administration. Choice D, taking a double dose if a dose is missed, is dangerous and should never be advised as it can lead to overdose and serious side effects.

3. While assessing a client receiving a blood transfusion, which finding requires immediate intervention?

• A. Temperature of 100.4°F (38°C).
• B. Blood pressure of 110/70 mm Hg.
• C. Heart rate of 90 beats per minute.
• D. Complaints of feeling cold.

Correct answer: C

Rationale: A heart rate of 90 beats per minute requires immediate intervention when assessing a client receiving a blood transfusion. This finding can indicate a potential transfusion reaction, such as a hemolytic reaction or fluid overload, which requires prompt evaluation and management to prevent serious complications. While a temperature of 100.4°F (38°C) may indicate a mild fever, it is not typically an immediate concern during a blood transfusion. A blood pressure of 110/70 mm Hg is within the normal range and does not necessitate immediate intervention. Complaints of feeling cold can be addressed but do not indicate an urgent need for intervention compared to the critical nature of a potential transfusion reaction indicated by an elevated heart rate.

4. The healthcare professional is conducting a community assessment to identify health needs. Which method is most effective for gathering comprehensive data?

• A. conducting focus groups with community members
• B. reviewing local health department reports
• C. surveying healthcare providers in the area
• D. analyzing hospital admission records

Correct answer: A

Rationale: Conducting focus groups with community members is the most effective method for gathering comprehensive data during a community assessment. This approach allows direct interaction with community members, fostering in-depth discussions that provide insights into the specific health needs and concerns of the community. Choice B, reviewing local health department reports, may offer valuable data but might not capture the nuanced perspectives and experiences of community members. Choice C, surveying healthcare providers, provides insights from a professional standpoint but may not fully represent the community's diverse health needs. Choice D, analyzing hospital admission records, offers information on healthcare utilization but may overlook important social determinants of health and community-specific issues that can only be addressed through direct engagement with community members.

5. A public health nurse is planning an educational campaign to reduce the incidence of hypertension in the community. Which group should be the primary target of this campaign?

• A. adolescents
• B. young adults
• C. middle-aged adults
• D. older adults

Correct answer: C

Rationale: The correct answer is C, middle-aged adults. Middle-aged adults are at a higher risk for developing hypertension due to lifestyle factors and aging. Targeting this group for preventive measures such as dietary changes, exercise, and stress management can have a significant impact on reducing the incidence of hypertension. Choices A, B, and D are less appropriate targets as adolescents generally have lower rates of hypertension, young adults are less likely to be affected by hypertension at this stage, and older adults may already have established hypertension or comorbidities that could make prevention more challenging.

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