Nursing Elites

1. The client with diabetes mellitus has gangrene of the toes to the midfoot. Which goal should be included in this client's plan of care?

• A. Restore skin integrity.
• B. Prevent infection.
• C. Promote healing.
• D. Improve nutrition.

Correct answer: B

Rationale: Preventing infection is crucial in clients with gangrene to halt the spread of infection and avert further complications. Infections can exacerbate tissue damage and lead to systemic complications, making infection prevention a priority in the care plan for this client. Restoring skin integrity and promoting healing may not be achievable goals until the infection is under control. Improving nutrition is important for overall health but may not be the priority when the immediate concern is preventing infection.

2. A client has a new prescription for prednisone. Which of the following statements should the nurse include in teaching the client?

• A. You may experience weight gain.
• B. Increase your intake of vitamin K.
• C. Expect increased urinary output.
• D. You may have dark, tarry stools.

Correct answer: A

Rationale: The correct answer is A. Weight gain is a common side effect of prednisone. The nurse should educate the client about the possibility of weight gain and the need to monitor it closely during treatment with prednisone. Choice B is incorrect because increasing vitamin K intake is not specifically related to prednisone therapy. Choice C is incorrect as prednisone is more likely to cause fluid retention rather than increased urinary output. Choice D is incorrect as dark, tarry stools are not a common side effect of prednisone.

3. A client has a new prescription for propranolol. Which of the following instructions should be included?

• A. Take the medication with food.
• B. Monitor heart rate daily.
• C. Increase intake of potassium-rich foods.
• D. Avoid consuming dairy products.

Correct answer: B

Rationale: The correct answer is to monitor heart rate daily. Propranolol is a beta-blocker that can lower heart rate and blood pressure, so it is essential to monitor heart rate regularly to detect any signs of bradycardia, a potential side effect of the medication. Choice A is incorrect because propranolol can be taken with or without food. Choice C is incorrect as increasing potassium-rich foods is not specifically required with propranolol. Choice D is also incorrect as there is no need to avoid consuming dairy products with propranolol.

4. The healthcare provider is teaching a client with hypertension about lifestyle modifications. Which recommendation should the healthcare provider include?

• A. Limit alcohol consumption to one drink per day.
• B. Increase sodium intake to maintain blood pressure.
• C. Exercise vigorously for at least 30 minutes daily.
• D. Avoid high potassium foods like bananas.

Correct answer: A

Rationale: Limiting alcohol intake is an essential lifestyle modification recommended for managing hypertension. Excessive alcohol consumption can raise blood pressure, so limiting it to one drink per day is beneficial in controlling hypertension. Alcohol moderation is a key part of a heart-healthy lifestyle for individuals with high blood pressure. Choice B is incorrect because increasing sodium intake can actually worsen hypertension by retaining water and increasing blood pressure. Choice C is incorrect because while exercise is important for overall health, moderate-intensity exercise is recommended for individuals with hypertension to avoid excessive strain on the heart. Choice D is incorrect because high potassium foods like bananas are actually beneficial for individuals with hypertension as they can help lower blood pressure.

5. A client with heart failure is being discharged with a prescription for digoxin (Lanoxin). The nurse should include which instruction in the discharge teaching?

• A. Take your pulse before each dose and hold the medication if your pulse is below 60 beats per minute
• B. Increase your fluid intake to at least 3 liters per day
• C. Report any weight loss of more than 2 pounds in a week
• D. Take the medication with meals to avoid gastrointestinal upset

Correct answer: A

Rationale: The correct instruction for a client taking digoxin is to monitor the pulse before each dose and hold the medication if the pulse is below 60 beats per minute. Digoxin can cause bradycardia, so it is crucial to assess the pulse rate before administration to prevent potential complications. Choices B, C, and D are incorrect because increasing fluid intake, reporting weight loss, or taking the medication with meals are not specific instructions related to the safe use of digoxin.

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