Nursing Elites

1. The client should include all of the following in teaching an obese client about nutritional needs and weight loss except:

• A. knowledge of food and food products
• B. development of a positive mental attitude
• C. adequate exercise
• D. starting a fast weight-loss diet

Correct answer: D

Rationale: When educating an obese client about nutritional needs and weight loss, it is crucial to emphasize a holistic approach that involves understanding food and food products, fostering a positive mental attitude, and incorporating adequate exercise. Initiating a fast weight-loss diet is not advisable due to potential health risks and lack of long-term sustainability. Therefore, this option stands out as the exception and should not be part of the client's learning. Choices A, B, and C are essential components of a healthy weight-loss plan and should be included in the client's education.

2. A home health care nurse is visiting a male African American client who was recently discharged from the hospital. Which family member does the nurse ensure is present when teaching the client about his prescribed medications?

• A. The client's grandson
• B. The client's mother
• C. The client's father
• D. The client's son

Correct answer: B

Rationale: In the African American family structure, the woman, especially the mother, often plays a central role in healthcare decisions and maintaining family health. It is essential for the nurse to involve the client's mother in teaching him about his prescribed medications as she may be responsible for his care and treatment decisions. While other family members may also be involved, the African American family is often matrifocal, emphasizing the importance of the mother's role. Therefore, it is crucial for the nurse to ensure the client's mother is present during medication teaching. Choices A, C, and D are incorrect as they do not align with the traditional African American family structure and the role of women in healthcare decisions.

3. A female client asks a nurse about the advantages of using a female condom. The nurse discusses which advantage with the client?

• A. That it offers protection against sexually transmitted infections (STIs)
• B. That it cannot be used along with a male condom
• C. That it does not have to be discarded after use and can be used several times before a new one must be obtained
• D. That it is 100% effective in preventing pregnancy

Correct answer: A

Rationale: The correct answer is that the female condom offers protection against sexually transmitted infections (STIs). Unlike the male condom, the female condom is a loose-fitting tubular polyurethane pouch that is anchored over the labia and cervix. It is used once and then discarded, making choice C incorrect. Female and male condoms should not be used together, so choice B is incorrect. Additionally, no contraceptive method is 100% effective in preventing pregnancy, making choice D incorrect.

4. A pregnant client asks a nurse about the use of noninvasive acupressure as a complementary alternative therapy to relieve nausea. The nurse provides which instruction?

• A. It is safe to try any type of complementary alternative therapy to relieve nausea
• B. The physician or nurse-midwife needs to provide a prescription for acupressure devices
• C. Devices that apply pressure alone are available over the counter
• D. Complementary alternative therapies should not be used during pregnancy

Correct answer: C

Rationale: The correct answer is 'Devices that apply pressure alone are available over the counter.' Acupressure over the Neiguan acupuncture point can be used as a complementary alternative therapy to relieve nausea during pregnancy. It can be performed with devices that apply pressure alone, which are available over the counter. Acupressure devices that apply electrical impulses over this point require a prescription. It is not safe to try any type of complementary alternative therapy during pregnancy, as some may be harmful to the mother and fetus. Therefore, the nurse should instruct the client about the availability of over-the-counter pressure devices for acupressure, which are generally safe to use.

5. When teaching a woman about possible side effects of hormone replacement therapy, the nurse should include information about all of the following except:

• A. Hypoglycemia in diabetic women.
• B. The possible return of monthly menses when taking combination hormones.
• C. Increased risk of gallbladder disease.
• D. Increased risk of breast, cervical, and ovarian cancer with long-term use.

Correct answer: A

Rationale: The correct answer is 'Hypoglycemia in diabetic women.' When educating a woman about hormone replacement therapy, it is important to discuss the possible side effects. It is true that monthly menses might return when taking combination hormones, as the progestin can cause this. Additionally, there is an increased risk of gallbladder disease associated with hormone replacement therapy. Furthermore, long-term use of hormone replacement therapy is linked to an increased risk of breast, cervical, and ovarian cancer. However, hypoglycemia is not a common side effect of hormone replacement therapy, especially in diabetic women. In fact, estrogen can have a positive impact on glucose control in some cases, so hypoglycemia would not be a typical concern.

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