Nursing Elites

1. Which instruction is most important for the nurse to include when teaching a client with limited mobility strategies to prevent venous thrombosis?

• A. Perform cough and deep breathing exercises hourly.
• B. Turn from side to side in bed at least every 2 hours.
• C. Dorsiflex and plantarflex the feet 10 times each hour
• D. Drink approximately 4 ounces of water every hour

Correct answer: C

Rationale: To reduce the risk of venous thrombosis, the nurse should instruct the client to perform dorsiflexion and plantar flexion exercises regularly. These exercises help promote venous return and prevent venous thrombus formation. Options A, B, and D are beneficial in managing other complications of immobility, such as atelectasis and pressure ulcers, but they are less effective in preventing venous thrombosis compared to dorsiflexion and plantar flexion exercises.

2. Which intervention would the nurse implement to develop a caring relationship with the client's family?

• A. Deciding health care options for the client
• B. Identifying the client's family members and their roles
• C. Declining to inform the client's family after performing a procedure
• D. Refraining from discussing the client's health with the family

Correct answer: B

Rationale: To establish a caring relationship with the client's family, the nurse should start by identifying the family members and understanding their roles in the client's life. This step is crucial in determining how they can contribute to the client's healthcare and support. Deciding healthcare options for the client (Choice A) is not the nurse's role; it should be a collaborative decision with the client and family. Declining to inform the client's family after a procedure (Choice C) goes against transparency and collaboration in care. Refraining from discussing the client's health with the family (Choice D) can hinder effective communication and support, which are essential in developing a caring relationship with the family.

3. 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.

4. At a senior citizens meeting, a healthcare professional talks with a client who has Type 1 diabetes mellitus. Which statement by the client during the conversation is most predictive of a potential for impaired skin integrity?

• A. ''I give myself insulin injections in my thighs.''
• B. ''Sometimes when I put my shoes on, I don't know where my toes are.''
• C. ''Here are my glucose readings that I noted on my calendar.''
• D. ''If I bathe more than once a week, my skin feels too dry.''

Correct answer: B

Rationale: The correct answer is when the client states, ''Sometimes when I put my shoes on, I don't know where my toes are.'' This statement indicates peripheral neuropathy, which can lead to a lack of sensation in the lower extremities. When clients are unable to feel pressure or pain in their feet, they are at a high risk for skin impairment, such as cuts, wounds, or ulcers. Option A is not directly related to impaired skin integrity, as self-administering insulin in the thighs does not pose a direct risk to skin integrity. Option C shows good glucose monitoring, which is important but does not directly indicate impaired skin integrity. Option D suggests dry skin due to infrequent bathing, which is more related to general skin care and not as predictive of impaired skin integrity as the statement in Option B.

5. According to the CDC, which of the following age groups is most likely to meet the criteria for major depression?

• A. 18-24 years
• B. 25-34 years
• C. 35-44 years
• D. 45-64 years

Correct answer: D

Rationale: According to the CDC, individuals aged 45-64 years are most likely to meet the criteria for major depression. While patients in the 18-24 year age group are more likely to report symptoms of depression, when it comes to major depression, the prevalence is higher in the 45-64 year age group. Choices A, B, and C are incorrect because the CDC indicates that major depression is most prevalent in the 45-64 year age group.

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