Nursing Elites

1. The LPN is caring for a client taking Lipitor (Atorvastatin). Which of these statements would indicate that the client may need reinforced teaching?

• A. "I take my Lipitor with a glass of milk after my breakfast."?
• B. "I take my Lipitor and wait 30 minutes before taking my other medications."?
• C. "I take my Lipitor 30 minutes after I eat something."?
• D. "I take my Lipitor and my other morning medications with my grapefruit juice at breakfast."?

Correct answer: D

Rationale: The correct answer is, 'I take my Lipitor and my other morning medications with my grapefruit juice at breakfast.' This statement indicates a need for reinforced teaching because grapefruit juice should be avoided when taking Lipitor. Grapefruit juice blocks the enzymes needed to break down the drug, which leads to excessive amounts of the drug in the body. Choices A, B, and C show appropriate timing and administration of Lipitor, whereas choice D poses a potential risk due to the interaction between grapefruit juice and Lipitor.

2. In the context of diagnostic genetic counseling, which of the following choices is typically not made by clients?

• A. Terminating the pregnancy.
• B. Preparing for the birth of a child with special needs.
• C. Accessing support services before the birth.
• D. Completing the grieving process before the birth.

Correct answer: D

Rationale: In diagnostic genetic counseling, clients may face difficult decisions based on test results. Terminating the pregnancy is a choice some clients may consider if severe abnormalities are detected. Preparing for the birth of a child with special needs involves getting ready to care for a child who may require extra attention and support. Accessing support services before the birth can help clients connect with resources and professionals for assistance during and after the pregnancy. Completing the grieving process before birth is not typically a choice made in the context of genetic counseling. The grieving process often starts or continues after distressing results and can extend beyond the birth of the child. Therefore, the correct answer is completing the grieving process before the birth.

3. If a client has chronic renal failure, which of the following sexual complications is the client at risk of developing?

• A. retrograde ejaculation
• B. decreased plasma testosterone
• C. hypertrophy of testicles
• D. state of euphoria

Correct answer: B

Rationale: In chronic renal failure, untreated, the client is at risk of developing decreased plasma testosterone. This condition leads to atrophy of the testicles and decreased spermatogenesis. Retrograde ejaculation is not a complication of chronic renal failure but can occur after transurethral resection of the prostate. The testicles atrophy in chronic renal failure; they do not hypertrophy. Additionally, chronic renal failure often leads to a state of depression, not euphoria.

4. A nurse reviewing a client's record notes that the result of the client's latest Snellen chart vision test was 20/80. The nurse interprets the client's results in which way?

• A. The client is legally blind.
• B. The client has normal vision.
• C. The client can read at a distance of 20 feet what a client with normal vision can read at 80 feet.
• D. The client can read at a distance of 80 feet what a client with normal vision can read at 20 feet.

Correct answer: D

Rationale: When interpreting visual acuity testing results using the Snellen chart, the recorded numeric fraction represents the distance the client is standing from the chart and the distance a normal eye could read that particular line. A reading of 20/80 means that the client can read at 20 feet what a client with normal vision can read at 80 feet. This indicates visual impairment but does not meet the criteria for legal blindness, which is defined as best-corrected vision in the better eye of 20/200 or worse. Normal visual acuity is 20/20. Therefore, the correct interpretation is that the client can read at a distance of 80 feet what a client with normal vision can read at 20 feet. Choice A is incorrect because 20/80 does not meet the criteria for legal blindness. Choice B is incorrect as the client's vision is impaired. Choice C is incorrect because it reverses the interpretation of the fraction.

5. A preschooler has successfully completed the test item 'counts 5 blocks' on the Denver II test. This pass is evidence of which of the following developmental concepts?

• A. centration
• B. causality
• C. nonreversibility
• D. conservation

Correct answer: D

Rationale: The ability of a preschooler to move five blocks to a piece of paper and state there are five blocks on the paper is evidence that the preschooler has the ability of conservation. This concept refers to the fact that the quantity of something doesn't change just because the shape, contour, and so on has changed. Five blocks are still five blocks, whether they are lying beside the paper, stacked on the paper, or moved to the paper. Centration is the ability to concentrate on one feature of a situation while neglecting all other aspects. Causality is based on the sequence of events, one event ordinarily following another. Non-reversibility refers to the inability of preschoolers to reverse their operations. They are only able to think forward, not retrace or reverse their thought processes.

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