Nursing Elites

1. The nurse has completed the admission assessment of a client and has determined that the client's body mass index (BMI) is 33.5 kg/m2. What health promotion advice should the nurse provide to the client?

• A. It would be very helpful if you could integrate more physical activity into your routine.
• B. You're considered to be overweight, so you should be diligent about maintaining a healthy diet.
• C. You might want to consider some of the surgical options that have been developed for treating obesity.
• D. With your permission, I'd like you to refer to a support group for individuals who live with severe obesity.

Correct answer: A

Rationale: Increasing physical activity is a key component of managing BMI and overall health.

2. An older adult with a diagnosis of Alzheimer's disease has been experiencing fecal incontinence, with no recent change in stool character noted by the nurse. What is the nurse's most appropriate intervention?

• A. Keep a food diary to identify foods that worsen the client's symptoms
• B. Provide the client with a bland, low-residue diet
• C. Toilet the client on a frequent, scheduled basis
• D. Collaborate with the primary provider to secure an order for loperamide

Correct answer: C

Rationale: The most appropriate intervention for an older adult with Alzheimer's disease experiencing fecal incontinence and no change in stool character is to toilet the client on a frequent, scheduled basis. Scheduled toileting can help manage incontinence by establishing a routine for bowel movements, which may aid in reducing episodes of fecal incontinence.

3. A patient with rheumatoid arthritis is prescribed methotrexate. What is an important teaching point for the nurse to provide?

• A. Take folic acid supplements as prescribed.
• B. Avoid alcohol completely.
• C. Expect to see immediate results.
• D. Limit fluid intake to 1 liter per day.

Correct answer: A

Rationale: The correct teaching point for a patient prescribed methotrexate is to take folic acid supplements as prescribed. Methotrexate can lead to a folate deficiency, which is why supplementing with folic acid is essential to reduce the risk of side effects such as mouth sores, nausea, and liver problems.

4. After a client's neck dissection surgery resulted in damage to the superior laryngeal nerve, what area of assessment should the nurse prioritize?

• A. The client's swallowing ability
• B. The client's ability to speak
• C. The client's management of secretions
• D. The client's airway patency

Correct answer: A

Rationale: Damage to the superior laryngeal nerve can lead to swallowing difficulties due to impaired laryngeal function. As a result, assessing the client's swallowing ability is crucial to prevent aspiration and ensure proper nutrition and hydration.

5. A client is admitted with a diagnosis of acute pancreatitis. Which laboratory value should the nurse monitor closely?

• A. Serum amylase.
• B. Serum sodium.
• C. Serum calcium.
• D. Serum potassium.

Correct answer: A

Rationale: In acute pancreatitis, serum amylase is a crucial laboratory value to monitor closely. Elevated levels of serum amylase are a key indicator of pancreatic inflammation and can help confirm the diagnosis of acute pancreatitis. Therefore, monitoring serum amylase levels is essential for assessing the progression and severity of the condition in a client with acute pancreatitis.

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