Nursing Elites

1. An older male client with Alzheimer's disease is admitted to an extended care facility. Which intervention should the PN include in the client's nursing care plan?

• A. Plan to have the same nursing staff provide care for the client whenever possible
• B. Describe the activities available to residents and encourage him to choose the ones he prefers
• C. Encourage the client to remain on the unit for three weeks until he is oriented to his new surroundings
• D. Introduce the client to the nursing staff and other residents as soon as possible

Correct answer: A

Rationale: The correct intervention for a client with Alzheimer's disease in an extended care facility is to plan to have the same nursing staff provide care whenever possible. Consistency in caregivers helps reduce confusion and anxiety in clients with Alzheimer’s disease, promoting a stable and supportive environment for the client. Choice B is incorrect as it focuses on activities rather than the consistency of caregivers. Choice C is incorrect as it suggests isolating the client, which can lead to increased confusion and distress. Choice D is incorrect as introducing the client to new people immediately can be overwhelming and may exacerbate their symptoms.

2. A client who is receiving chemotherapy has developed stomatitis. Which instruction should the nurse provide the UAP who is assisting with the care of this client?

• A. Keep the room environment free of unpleasant odors
• B. Gather supplies for protective environmental precautions
• C. Assist the client with feeding at meal times
• D. Provide gentle and meticulous mouth care

Correct answer: D

Rationale: Providing gentle and meticulous mouth care is critical for a client with stomatitis as it helps prevent further irritation and infection of the mucous membranes. Keeping the room environment free of unpleasant odors (Choice A) is important for the client's comfort but not directly related to managing stomatitis. Gathering supplies for protective environmental precautions (Choice B) is not relevant to addressing stomatitis. Assisting the client with feeding at meal times (Choice C) is important for overall care but does not specifically target the care needed for stomatitis.

3. When administering an analgesic to a client with low back pain, which intervention should the practical nurse implement to promote the effectiveness of the medication?

• A. Massage the lower back and position the client in proper alignment
• B. Encourage the client to ambulate frequently and take deep breaths
• C. Assist the client in performing passive and active range of motion exercises
• D. Give medication with a full glass of water and offer high-fiber foods

Correct answer: A

Rationale: Massaging the lower back and positioning the client in proper alignment can help relieve muscle tension and enhance the effectiveness of analgesics by providing additional comfort and promoting better pain management. This intervention directly addresses the site of pain and can improve the medication's efficacy. Choices B, C, and D are incorrect because while they may have benefits in other situations, they are not directly related to promoting the effectiveness of analgesics in clients with low back pain. Encouraging ambulation and deep breathing, assisting with range of motion exercises, and offering water and high-fiber foods are important for overall patient care but are not specific to enhancing analgesic effectiveness in this context.

4. At the end of a 12-hour shift, the PN observes the urine in a client's drainage bag as seen in the picture. Which action should the PN take next?

• A. Offer to administer a prescribed PRN analgesic
• B. Obtain a finger stick capillary glucose level
• C. Determine if the client's bladder feels distended
• D. Note the most recent white blood cell count

Correct answer: D

Rationale: Noting the white blood cell count is the most appropriate action in this situation. Changes in urine appearance could indicate infection, and assessing the white blood cell count helps in evaluating the possibility of infection. This is crucial for understanding the client's overall condition. The other options are not directly related to assessing infection based on urine appearance. Offering analgesics, checking glucose levels, or determining bladder distention may not address the underlying issue of a potential infection.

5. At what age does a 9-year-old child typically lose which of the following teeth?

• A. Central incisor
• B. Second molar
• C. Lateral incisor
• D. Cuspid

Correct answer: A

Rationale: A 9-year-old child typically loses their central incisors, not the lateral incisors or second molars. The central incisors are usually among the first teeth that children lose around 6 to 7 years of age, as part of the natural process of shedding primary teeth to make way for permanent teeth. The second molars and cuspids are typically lost later in the mixed dentition phase. Therefore, option A, 'Central incisor,' is the correct answer.

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