Nursing Elites

1. Which lifestyle change should be emphasized for a client with hypertension?

• A. Increase sodium intake to prevent fluid retention
• B. Reduce sodium and caffeine intake
• C. Increase protein intake to promote muscle strength
• D. Increase intake of high-fat foods

Correct answer: B

Rationale: The correct answer is B: 'Reduce sodium and caffeine intake.' Clients with hypertension benefit from reducing sodium intake as it can help lower blood pressure levels. Caffeine also has a vasoconstrictive effect, which can increase blood pressure. Choices A, C, and D are incorrect. Increasing sodium intake would exacerbate hypertension due to fluid retention. While protein intake is important for overall health, it is not a primary focus in managing hypertension. Increasing intake of high-fat foods can lead to weight gain and negatively impact heart health, which is counterproductive for someone with hypertension.

2. What are the key nursing interventions for a patient receiving diuretic therapy?

• A. Monitor electrolyte levels and administer potassium as needed
• B. Restrict fluid intake and provide a low-sodium diet
• C. Encourage oral fluids and increase dietary potassium
• D. Provide high-sodium foods to improve electrolyte balance

Correct answer: A

Rationale: The correct answer is A: Monitor electrolyte levels and administer potassium as needed. Patients on diuretic therapy are at risk of electrolyte imbalances, particularly low potassium levels. Monitoring electrolytes and administering potassium as needed are crucial nursing interventions to prevent imbalances. Choice B is incorrect because restricting fluid intake and providing a low-sodium diet are not typically indicated for patients on diuretic therapy. Choice C is incorrect as encouraging oral fluids and increasing dietary potassium can exacerbate electrolyte imbalances in patients on diuretics. Choice D is incorrect as providing high-sodium foods would worsen electrolyte balance issues in patients on diuretic therapy.

3. Which nursing intervention is best for a client with constipation?

• A. Encourage the client to remain in bed to avoid straining
• B. Administer a stool softener as prescribed
• C. Increase fiber intake through dietary changes
• D. Encourage regular exercise to promote bowel movement

Correct answer: C

Rationale: Increasing fiber intake is the most appropriate nursing intervention for a client experiencing constipation. Fiber helps add bulk to the stool, making it easier to pass and promoting regular bowel movements. Encouraging the client to remain in bed may exacerbate constipation by reducing movement and promoting inactivity. While stool softeners can be beneficial, they are typically used as a short-term solution and may not address the underlying issue of low fiber intake. Regular exercise is important for overall bowel health; however, in the immediate management of constipation, increasing fiber intake is the most effective intervention.

4. A nurse is preparing to administer enoxaparin subcutaneously to a client. Which of the following actions should the nurse take?

• A. Administer the medication into the client's nondominant arm.
• B. Pull the skin laterally before inserting the needle.
• C. Massage the injection site after administration.
• D. Pinch the skin between the thumb and forefinger.

Correct answer: D

Rationale: The correct action the nurse should take when administering enoxaparin subcutaneously is to pinch the skin between the thumb and forefinger. Pinching the skin helps to lift the subcutaneous tissue, reducing the risk of injecting into the muscle. Choices A, B, and C are incorrect. Choice A is not relevant as the injection site for enoxaparin is typically in the abdomen or thigh, not the arm. Choice B is incorrect as pulling the skin laterally is not a recommended technique for subcutaneous injections. Choice C is also incorrect as massaging the injection site after administration can increase the risk of bleeding or bruising.

5. How can pain in a post-operative patient be managed effectively?

• A. Administer analgesics as prescribed
• B. Encourage deep breathing exercises
• C. Provide distractions
• D. All of the above

Correct answer: D

Rationale: Managing pain in a post-operative patient requires a multimodal approach, which includes both pharmacological and non-pharmacological strategies. Administering analgesics as prescribed helps in controlling pain pharmacologically. Encouraging deep breathing exercises can aid in pain management by promoting relaxation and reducing anxiety. Providing distractions, such as music or activities, can help divert the patient's attention from pain. Therefore, all the given options are essential components of an effective pain management plan for post-operative patients.

Similar Questions