Nursing Elites

1. A 4-year-old client is unable to go to sleep at night in the hospital. Which nursing intervention best promotes sleep for the child?

• A. turning out the room light and closing the door
• B. tiring the child during the evening with quiet activities
• C. identifying the child's home bedtime rituals and following them
• D. encouraging visitation by friends during the evening

Correct answer: C

Rationale: For a 4-year-old client struggling to sleep in the hospital, it is essential to identify and replicate their home bedtime rituals. This familiarity can provide comfort and promote better sleep. Turning out the room light and closing the door (Choice A) might increase the child's fear by plunging the room into darkness, making it an incorrect choice. Tiring the child with quiet activities (Choice B) is incorrect as it may stimulate rather than calm the child. Encouraging visitation by friends (Choice D) can lead to increased excitement, hindering the child's ability to fall asleep instead of promoting a restful environment.

2. Which of the following foods is a complete protein?

• A. corn
• B. eggs
• C. peanuts
• D. sunflower seeds

Correct answer: B

Rationale: Eggs are considered a complete protein because they contain all nine essential amino acids required by the human body. In contrast, corn, peanuts, and sunflower seeds are incomplete proteins as they lack one or more essential amino acids. Corn, although a staple food for many cultures, is deficient in the amino acids lysine and tryptophan. Peanuts are low in the amino acid methionine, and sunflower seeds are low in lysine. Therefore, eggs are the correct answer as a complete protein source.

3. The LPN participates in a home visit for a client with Type 2 Diabetes who has been taking Metformin for 3 years. The client states that for the past 3 months, they have been trying a vegan diet and experiencing fatigue, confusion, and mood changes. What is a likely cause of the new symptoms?

• A. vitamin B12 deficiency
• B. chronic hypoglycemia
• C. vitamin D deficiency
• D. increased tolerance to Metformin

Correct answer: A

Rationale: The correct answer is vitamin B12 deficiency. Long-term use of Metformin can lead to vitamin B12 deficiency, and a vegan diet is low in vitamin B12. Symptoms of vitamin B12 deficiency include anemia, fatigue, confusion, and mood changes. Chronic hypoglycemia is unlikely in a client with Type 2 Diabetes who has been taking Metformin as it typically causes hyperglycemia. Vitamin D deficiency usually presents with symptoms related to bones and muscles, not confusion and mood changes. Increased tolerance to Metformin does not explain the client's new symptoms, which are more indicative of a nutritional deficiency like vitamin B12.

4. During a voice test, how should the nurse provide words for the client to repeat?

• A. Spoken in a soft tone of voice by the nurse about 5 feet in front of the client
• B. Whispered by the nurse from the client's side at a distance of 1 to 2 feet from the ear being tested
• C. Spoken by the nurse from the client's side in a normal tone of voice about 10 feet from the ear being tested
• D. Whispered at a distance of 20 feet by the nurse while he or she is standing in front of the client

Correct answer: B

Rationale: During a voice test, the nurse should whisper words from the client's side at a distance of 1 to 2 feet from the ear being tested. This distance helps prevent transmission around the head and ensures accurate testing of one ear at a time. By standing close to the client and whispering, the nurse prevents lip-reading and compensatory actions by the client. The client with normal hearing should be able to repeat each word correctly. Choices A, C, and D are incorrect. Choice A is wrong as the voice should be whispered, not spoken in a soft tone. Choice C is inaccurate because a distance of 10 feet is too far for precise testing. Choice D is incorrect as whispering from a distance of 20 feet would not effectively test the client's hearing.

5. When caring for an elderly client and providing education, which of the following would be the least appropriate for the nurse to do?

• A. The nurse speaks loudly.
• B. The nurse allows additional time after each instruction to allow the client to process.
• C. The nurse provides supplemental written resources.
• D. The nurse breaks up the education into multiple shorter sessions.

Correct answer: A

Rationale: Speaking loudly is inappropriate when caring for an elderly client. It is essential to assess the client for a hearing impairment and provide appropriate assistance if needed. Elderly clients may require more time to process information due to slower reaction times, benefit from shorter sessions as they fatigue easily, and can absorb supplemental written resources effectively. Therefore, speaking loudly may not be conducive to effective communication and may not cater to the specific needs of the elderly client, unlike the other options provided.

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