Nursing Elites

1. What is the best way to manage a patient's pain postoperatively?

• A. Administer analgesics regularly
• B. Administer pain medication PRN
• C. Encourage deep breathing exercises
• D. Provide distraction techniques

Correct answer: A

Rationale: The correct answer is A: Administer analgesics regularly. Postoperative pain management often requires a scheduled, around-the-clock administration of analgesics to maintain a consistent level of pain relief and minimize the risk of breakthrough pain. Choice B, administering pain medication PRN (as needed), may lead to inadequate pain control as the medication is not given preemptively. Choice C, encouraging deep breathing exercises, can be beneficial for pain management but should be used as an adjunct to analgesic therapy. Choice D, providing distraction techniques, may help some patients cope with pain but should not be the primary method of pain management postoperatively.

2. A client is postoperative following cataract surgery. Which of the following instructions should the nurse include?

• A. Avoid lying flat for 24 hours after surgery.
• B. Avoid bending at the waist.
• C. Wear an eye patch at night for 1 week.
• D. Sleep on your affected side to reduce discomfort.

Correct answer: B

Rationale: The correct instruction that the nurse should include for a client postoperative following cataract surgery is to avoid bending at the waist. Bending at the waist can increase intraocular pressure, which is not recommended after cataract surgery. Choices A, C, and D are incorrect because lying flat for 24 hours after surgery may not be necessary, wearing an eye patch at night for a week is not a standard postoperative instruction for cataract surgery, and sleeping on the affected side may not necessarily reduce discomfort and can increase pressure on the eye.

3. A client with heart failure at risk for pulmonary edema should receive which intervention to improve oxygenation?

• A. Place the client in a supine position.
• B. Encourage the client to increase fluid intake.
• C. Elevate the client's legs when in bed.
• D. Administer oxygen via non-rebreather mask.

Correct answer: D

Rationale: Administering oxygen via a non-rebreather mask is the appropriate intervention for a client at risk for pulmonary edema as it helps improve oxygenation by delivering a high concentration of oxygen. Placing the client in a supine position can exacerbate pulmonary edema by increasing venous return to the heart, leading to fluid overload. Encouraging increased fluid intake is contraindicated in clients with heart failure and at risk for pulmonary edema, as it can worsen fluid accumulation. Elevating the client's legs when in bed is more appropriate for clients with conditions such as venous insufficiency or edema in the lower extremities, not for pulmonary edema.

4. A nurse is discussing group treatment and therapy with a client. The nurse should include which of the following as being a characteristic of a therapeutic group?

• A. The group is organized in an autocratic structure
• B. The group encourages members to focus on a particular issue
• C. The group must be led by a licensed psychiatrist
• D. The group encourages clients to form dependent relationships

Correct answer: B

Rationale: The correct answer is B. Therapeutic groups indeed encourage members to focus on particular issues. This focus helps individuals address specific concerns, work through challenges, and support one another in a structured setting. Choice A is incorrect because therapeutic groups typically promote a democratic structure that values input from all members rather than an autocratic one. Choice C is incorrect as therapeutic groups can be led by various mental health professionals, not solely by licensed psychiatrists. Choice D is incorrect; therapeutic groups aim to foster independent growth and self-reliance rather than promoting dependent relationships.

5. A nurse is providing discharge teaching to a client who has chronic kidney disease and is receiving hemodialysis. What dietary instruction should the nurse provide?

• A. Take magnesium hydroxide for indigestion.
• B. Drink at least 3L of fluid daily.
• C. Eat 1g/kg of protein per day.
• D. Consume foods high in potassium.

Correct answer: C

Rationale: For a client with chronic kidney disease receiving hemodialysis, consuming 1g/kg of protein per day is important. This amount helps manage the condition without overburdening the kidneys. Choice A is incorrect because magnesium hydroxide is not specifically recommended for clients with chronic kidney disease. Choice B is not accurate as fluid intake needs to be individualized based on the client's condition and dialysis status. Choice D is incorrect because foods high in potassium should generally be limited for individuals with kidney disease undergoing hemodialysis to prevent hyperkalemia.

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