Nursing Elites

1. The nurse is teaching a client with diabetes about foot care. Which instruction is most important to prevent complications?

• A. Soak feet in warm water daily
• B. Apply moisturizer between the toes
• C. Wear cotton socks
• D. Inspect feet daily for cuts or sores

Correct answer: D

Rationale: The correct answer is D: Inspect feet daily for cuts or sores. Daily foot inspection is crucial for clients with diabetes to detect early signs of injury or infection. Soaking feet in warm water daily (choice A) can lead to skin maceration, making the skin more susceptible to breakdown. Applying moisturizer between the toes (choice B) can increase moisture and the risk of fungal infections. While wearing cotton socks (choice C) is beneficial for diabetic foot care, it is not as crucial as daily foot inspections to prevent complications.

2. A client with a diagnosis of rheumatoid arthritis is prescribed methotrexate. What is the primary action of this medication?

• A. Increases joint lubrication
• B. Reduces inflammation by suppressing the immune system
• C. Enhances bone density
• D. Stimulates cartilage regeneration

Correct answer: B

Rationale: The correct answer is B: Methotrexate is an immunosuppressant that works by suppressing the immune system, thereby reducing inflammation in rheumatoid arthritis. Methotrexate does not directly increase joint lubrication (Choice A) as its primary action is on the immune system. Choices C and D are incorrect since methotrexate does not enhance bone density or stimulate cartilage regeneration. It is crucial for healthcare providers to understand the mechanism of action of medications to provide safe and effective care to patients.

3. Which client assessment falls within the scope of practice for the practical nurse?

• A. An agitated client with bilateral wrist restraints
• B. New admission of a client with deep vein thrombosis
• C. Return of a post-anesthesia client following a colon resection
• D. Transfer of a client with sepsis from a long-term care facility

Correct answer: B

Rationale: The correct answer is B because assessing a new deep vein thrombosis (DVT) patient is within the scope of practical nursing. It involves monitoring and supporting the circulatory system health, which is a common responsibility for practical nurses. Choices A, C, and D involve scenarios that are typically beyond the initial assessment and care provided by practical nurses. An agitated client with bilateral wrist restraints may require immediate intervention by higher-level healthcare providers due to safety concerns and potential underlying issues. The return of a post-anesthesia client following a colon resection and the transfer of a client with sepsis involve more specialized care that goes beyond the typical responsibilities of a practical nurse, often requiring interventions from registered nurses or physicians.

4. A client with hypothyroidism is taking levothyroxine (Synthroid). Which symptom should prompt the nurse to notify the healthcare provider?

• A. Weight gain
• B. Bradycardia
• C. Nervousness and tremors
• D. Fatigue

Correct answer: C

Rationale: The correct answer is C: Nervousness and tremors. These symptoms may indicate hyperthyroidism resulting from excessive dosing of levothyroxine. Weight gain (Choice A) is a common symptom of hypothyroidism and may indicate undertreatment or inadequate dosing. Bradycardia (Choice B) is a symptom of hypothyroidism and may improve with levothyroxine therapy; it does not typically indicate an urgent need for healthcare provider notification. Fatigue (Choice D) is a symptom of hypothyroidism and can persist even with levothyroxine treatment, so it is not a symptom that would require immediate notification of the healthcare provider.

5. The nurse explains the 2-week dosage prescription of prednisone (Deltasone) to a client who has poison ivy over multiple skin surfaces. What should the nurse emphasize about the dosing schedule?

• A. Decrease the dosage daily as prescribed
• B. Monitor oral temperature daily
• C. Take the prednisone with meals
• D. Return for blood glucose monitoring in one week

Correct answer: A

Rationale: The correct answer is A: 'Decrease the dosage daily as prescribed.' Tapering the dosage of prednisone is crucial to prevent withdrawal symptoms and minimize the side effects of corticosteroid therapy. Decreasing the dosage gradually over time allows the body to adjust and reduces the risk of adrenal insufficiency. Choices B, C, and D are incorrect. Monitoring oral temperature daily, taking prednisone with meals, or returning for blood glucose monitoring in one week are not specific to the dosing schedule of prednisone for poison ivy treatment.

Similar Questions