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. The nurse is making a home visit with a client diagnosed with Alzheimer's disease. The client recently started on lorazepam (Ativan) due to increased anxiety. The nurse is cautioning the family about the use of lorazepam (Ativan). The nurse should instruct the family to report which of the following significant side effects to the healthcare provider?

• A. Paradoxical excitement
• B. Headache
• C. Slowing of reflexes
• D. Fatigue

Correct answer: A

Rationale: The correct answer is A, paradoxical excitement. Lorazepam can cause an unexpected response of paradoxical excitement, which should be reported to the healthcare provider. This reaction is characterized by increased anxiety, restlessness, and agitation instead of the expected calming effect. Choices B, C, and D are incorrect because headache, slowing of reflexes, and fatigue are more common side effects of lorazepam and may not warrant immediate reporting unless severe or persistent.

3. What are the potential complications of a patient receiving hemodialysis?

• A. Infection and hypotension
• B. Pulmonary embolism and fluid overload
• C. Blood clot formation and electrolyte imbalance
• D. Low blood pressure and nausea

Correct answer: A

Rationale: Corrected Question: What are the potential complications of a patient receiving hemodialysis? Rationale: Infection and hypotension are common complications in patients undergoing hemodialysis. Pulmonary embolism and fluid overload (Choice B) are less common complications associated with hemodialysis. Blood clot formation and electrolyte imbalance (Choice C) are also potential complications but are not as common as infection and hypotension. Low blood pressure and nausea (Choice D) can occur but are not as prevalent as infection and hypotension.

4. When reviewing the medical record of a client with dementia, what should the nurse prioritize addressing?

• A. Mild confusion in the morning
• B. Restlessness and agitation
• C. Incontinence
• D. Frequent wandering at night

Correct answer: B

Rationale: When caring for clients with dementia, addressing restlessness and agitation is a priority as it can lead to distress, safety risks, and potential harm to the client or others. Restlessness and agitation are common behavioral symptoms of dementia and can indicate unmet needs, discomfort, or confusion. Managing these symptoms promptly can help improve the client's quality of life and prevent complications such as falls, injuries, or escalation of challenging behaviors. While other issues like mild confusion, incontinence, and wandering are also important to address, managing restlessness and agitation takes precedence due to its immediate impact on the client's well-being and safety.

5. Which assessment finding is expected with myxedema?

• A. Increased pulse rate
• B. Decreased temperature
• C. Fine tremors
• D. Weight loss

Correct answer: B

Rationale: Myxedema is characterized by a decreased metabolic rate, leading to manifestations such as decreased temperature. Therefore, the correct assessment finding expected with myxedema is a decreased temperature. Choices A, C, and D are incorrect because myxedema typically presents with a decreased pulse rate, not an increased pulse rate, absence of fine tremors (which are more common in hyperthyroidism), and weight gain rather than weight loss.

Similar Questions