Nursing Elites

1. The nurse is evaluating teaching about drug therapy to treat gout. Which statement by the client demonstrates an understanding of the use of allopurinol to treat Gout?

• A. I need to take the prescribed amount of the drug to get rid of my gout.
• B. I need to take this drug every day to keep from having any flare-ups.
• C. I should take this drug when I have gout attacks to reduce symptoms.
• D. The pain and swelling can be controlled by taking this drug every day.

Correct answer: B

Rationale: Taking allopurinol every day helps to prevent gout flare-ups by reducing uric acid levels.

2. The nurse is caring for a client with acute pancreatitis. Which laboratory result is most indicative of this condition?

• A. Elevated serum amylase
• B. Decreased serum bilirubin
• C. Increased blood urea nitrogen (BUN)
• D. Decreased alkaline phosphatase

Correct answer: A

Rationale: Elevated serum amylase is the most indicative laboratory result of acute pancreatitis. In this condition, the pancreas becomes inflamed, leading to the leakage of amylase and lipase into the bloodstream. Elevated serum amylase levels are a classic finding in acute pancreatitis. Choices B, C, and D are not typically associated with acute pancreatitis. Decreased serum bilirubin, increased blood urea nitrogen (BUN), and decreased alkaline phosphatase levels are not specific markers for acute pancreatitis.

3. The mother of a child who has been diagnosed with varicella asks the nurse when the child can return to school. When is the child no longer contagious?

• A. When the fever dissipates
• B. After the incubation period
• C. When the lesions have healed
• D. When the lesions are crusted over

Correct answer: D

Rationale: The correct answer is D: 'When the lesions are crusted over.' Varicella is no longer contagious once the lesions are dry and crusted. This stage indicates that the active viral shedding has significantly decreased, reducing the risk of transmission. Choice A, 'When the fever dissipates,' is incorrect because the presence of fever does not necessarily correlate with the contagiousness of varicella. Choice B, 'After the incubation period,' is incorrect as the incubation period occurs before the onset of symptoms and is not relevant to determining contagiousness. Choice C, 'When the lesions have healed,' is incorrect as healed lesions can still be contagious if they are not crusted over.

4. The wife of a client with Parkinson's disease expresses concern because her husband has lost so much weight. Which teaching is best for the nurse to provide?

• A. Invite friends over regularly to share meal times
• B. Encourage the client to drink clear liquids between meals
• C. Coach the client to make an intentional effort to swallow
• D. Talk to the healthcare provider about prescribing an appetite stimulant

Correct answer: A

Rationale: The best teaching for the nurse to provide is to invite friends over regularly to share meal times. This can help in making meal times more enjoyable for the client with Parkinson's disease, potentially encouraging him to eat more. Encouraging clear liquids between meals (choice B) may not address the underlying issue of weight loss. Coaching the client to make an intentional effort to swallow (choice C) may not be effective if the weight loss is due to other factors related to Parkinson's disease. While prescribing an appetite stimulant (choice D) could be an option, it is usually recommended to explore non-pharmacological interventions first, making choice A the most appropriate initial teaching intervention.

5. On the first postoperative day, the nurse finds an older male client disoriented and trying to climb over the bed railing. Previously, he was oriented to person, place, and time on admission. Which intervention should the nurse implement first?

• A. Administer a sedative.
• B. Determine the client’s blood pressure.
• C. Apply soft restraints.
• D. Call for assistance.

Correct answer: B

Rationale: The correct intervention the nurse should implement first is to determine the client’s blood pressure. Assessing the blood pressure is crucial in this situation to rule out physiological causes like hypotension leading to the client's disorientation. Administering a sedative (Choice A) without understanding the underlying cause may worsen the situation. Applying soft restraints (Choice C) should not be the initial action and can be considered later if necessary. Calling for assistance (Choice D) may be needed eventually, but assessing the client's blood pressure takes precedence to address the immediate concern.

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