Nursing Elites

1. Which of the following interventions is most appropriate when working with the family of a client who is being treated for substance abuse?

• A. Advocate for the client before the family
• B. Provide referrals for community resources and support groups
• C. Take the side of the family before the client
• D. Both B and C

Correct answer: B

Rationale: When working with the family of a client undergoing substance abuse treatment, it is crucial to support not only the client but also their family. Providing referrals for community resources and support groups is an effective intervention as it helps the family access additional support and information to cope with the challenges related to the client's substance abuse. This empowers the family to enhance their understanding of the situation and develop effective coping strategies. Advocating for the client before the family (choice A) may lead to conflicts and hinder the therapeutic process, while taking the side of the family before the client (choice C) can jeopardize the client's progress and trust. Therefore, the most appropriate intervention in this scenario is to provide referrals for community resources and support groups to ensure holistic care for both the client and their family.

2. Which activity would be most beneficial for a school-age client diagnosed with a chronic illness to enhance a sense of accomplishment?

• A. Wearing make-up
• B. Making up missed work
• C. Participating in sports activities
• D. Participating in creative activities

Correct answer: B

Rationale: Making up missed work is an essential activity that can help a school-age client diagnosed with a chronic illness feel a sense of accomplishment. By catching up on missed work, the child can regain a sense of control and productivity, which can be empowering during a challenging time. Wearing make-up is more related to personal grooming and self-expression, which may not directly contribute to a sense of accomplishment in this context. Participating in sports activities is beneficial for peer relationships and physical health but may not address the immediate need for accomplishment in the academic setting. Engaging in creative activities fosters cognitive development but may not directly address the sense of achievement associated with completing academic tasks.

3. Under what patient conditions or situations are restraints sometimes used?

• A. As punishment when the patient is uncontrollable
• B. To prevent the patient from pulling their IV out
• C. When a patient is a danger to self and others
• D. Both B and C

Correct answer: D

Rationale: Restraints are sometimes used to prevent a patient from pulling out their IV or another life-saving tube and when the person poses a serious danger to themselves and/or others. Restraints are never used as a form of punishment. Choice A is incorrect because restraints are not utilized for punishment but for patient safety and care. Choice B and C are correct because they reflect the appropriate and necessary situations where restraints may be used in healthcare settings.

4. A female client with frequent urinary tract infections (UTIs) asks the nurse to explain her friend's advice about drinking a glass of juice daily to prevent future UTIs. Which response is best for the nurse to provide?

• A. Orange juice has vitamin C that deters bacterial growth.
• B. Apple juice is the most useful in acidifying the urine.
• C. Cranberry juice stops pathogens' adherence to the bladder.
• D. Grapefruit juice increases absorption of most antibiotics.

Correct answer: C

Rationale: The correct answer is 'Cranberry juice stops pathogens' adherence to the bladder.' Cranberry juice maintains urinary tract health by reducing the adherence of Escherichia coli bacteria to cells within the bladder. This helps prevent UTIs. Options A, B, and D are incorrect because orange juice with vitamin C, apple juice for urine acidification, and grapefruit juice for antibiotic absorption do not have the same proven effectiveness in preventing UTIs as cranberry juice does.

5. To reduce the risk of venous thrombosis, which measure should the nurse instruct the client in to promote venous return?

• A. Instruct in the use of the incentive spirometer.
• B. Elevate the head of the bed during all meals.
• C. Use aseptic technique to change the dressing.
• D. Encourage frequent ambulation in the hallway.

Correct answer: D

Rationale: To prevent venous thrombus formation, promoting venous return is crucial. Encouraging frequent ambulation in the hallway helps prevent venous stasis and reduces the risk of thrombus formation in immobile clients. Option A (using the incentive spirometer) aids in alveolar expansion to prevent atelectasis, not specifically venous thrombosis. Option B (elevating the head of the bed during meals) reduces the risk of aspiration, not venous thrombosis. Option C (using aseptic technique for dressing changes) reduces the risk of postoperative infection, not specifically venous thrombosis. Therefore, among the options provided, encouraging frequent ambulation in the hallway is the most effective measure to prevent venous thrombosis.

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