Nursing Elites

1. You are creating a teaching plan for a patient with newly diagnosed migraine headaches. Which key item should NOT be included in the teaching plan?

• A. Avoid foods that contain tyramine, such as alcohol and aged cheese.
• B. Avoid drugs such as Tagamet, nitroglycerin, and Nifedipine.
• C. Continue taking estrogen as prescribed by your physician.
• D. A potential side effect of medications is rebound headache.

Correct answer: C

Rationale: The correct answer is C: Continue taking estrogen as prescribed by your physician. Medications such as estrogen supplements may actually trigger a migraine headache attack. Fluctuations in estrogen, such as before or during menstrual periods, pregnancy, and menopause, seem to trigger headaches in many women. Choices A and B are important to include in the teaching plan for a patient with migraines as avoiding foods containing tyramine and certain drugs can help prevent migraine triggers. Choice D is also relevant as it is essential for the patient to be aware of potential side effects of medications, including rebound headaches.

2. The client has a long leg cast. During discharge teaching about appropriate exercises for the affected extremity, the nurse should recommend:

• A. Isometric
• B. Range of motion
• C. Aerobic
• D. Isotonic

Correct answer: D

Rationale: The nurse should recommend isometric exercises for the muscles of the casted extremity. Isometric exercises involve contracting and relaxing muscles without moving the affected part. This type of exercise helps maintain muscle strength without moving the joint, which is important for clients with immobilized extremities. Range of motion exercises involve moving the joint through its full range of motion, which may not be suitable for a client with a long leg cast. Aerobic exercises focus on increasing cardiovascular endurance and may not be appropriate for a client with a casted extremity. Isotonic exercises involve muscle contractions with movement, which may not be safe for the affected extremity in a cast.

3. A client on an acute mental health unit reports hearing voices that are stating, "kill your doctor"?. Which of the following actions should the nurse take first?

• A. Encourage the client to participate in group therapy on the unit.
• B. Initiate one-to-one observation of the client.
• C. Focus the client on reality.
• D. Notify the provider of the client's statement.

Correct answer: B

Rationale: When a client experiences command hallucinations, such as being told to harm someone, the priority is ensuring the safety of the client and others. Initiating one-to-one observation allows for close monitoring and intervention to prevent harm. Encouraging participation in group therapy may not be appropriate or safe at this time. Focusing the client on reality may not be effective when experiencing hallucinations, and notifying the provider should come after immediate safety measures have been taken.

4. Sinusitis is caused by:

• A. Bacteria
• B. Fungus
• C. Virus
• D. Any of the above

Correct answer: D

Rationale: Sinusitis can be caused by bacteria, viruses, or fungi. While bacterial infections are the most common cause, viral or fungal infections can also lead to sinusitis. Therefore, the correct answer is 'Any of the above.' Choices A, B, and C are incorrect because they only represent individual causes of sinusitis, whereas choice D encompasses all possible causes.

5. The nurse is providing disease prevention education to a 63-year-old woman with a negative family history of breast cancer. The nurse recommends the patient schedule mammograms with which frequency?

• A. Every 5 years
• B. Every 10 years
• C. Every other year
• D. Once a year

Correct answer: C

Rationale: Mammograms, along with breast self-examinations and other routine tests, are key for the early diagnosis and treatment of breast cancer. All major societies (WHO, ACS, USPSTF) recommend a screening mammogram every two years in women of this age at average risk of breast cancer. The recommended frequency may change if there are identified family history and significant risk factors. Choosing 'Once a year' is too frequent and not aligned with current guidelines. Opting for 'Every 5 years' or 'Every 10 years' intervals is not adequate for regular breast cancer screening and may increase the risk of cancer progression. Therefore, 'Every other year' is the most appropriate choice for this patient without a family history of breast cancer.

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