Nursing Elites

1. A client in the second trimester of pregnancy asks how to treat constipation. Which of the following should the nurse recommend?

• A. Decrease intake of vitamins and supplements to every other day
• B. Eat 15 g of fiber per day
• C. Consume 48 ounces of water daily
• D. Drink hot water with lemon juice each morning

Correct answer: D

Rationale: The correct answer is D: Drink hot water with lemon juice each morning. Drinking hot water with lemon juice can help stimulate bowel movements, making it a natural and safe recommendation for pregnant clients experiencing constipation. Choice A is incorrect because reducing vitamin and supplement intake may not directly address constipation. Choice B, eating 15 g of fiber per day, could be helpful but may not be as effective as the correct answer for immediate relief. Choice C, consuming 48 ounces of water daily, is essential for overall health but may not be as directly effective as the correct answer in alleviating constipation.

2. A client with diabetes mellitus is receiving education on foot care. Which of the following instructions should the nurse include?

• A. Apply lotion between the toes.
• B. Cut toenails straight across.
• C. Use a heating pad to warm the feet.
• D. Soak feet in warm water daily.

Correct answer: B

Rationale: The correct answer is B: Cut toenails straight across. This instruction is vital for clients with diabetes as it helps prevent ingrown toenails and infections, reducing the risk of foot ulcers. Applying lotion between the toes (choice A) should be avoided as it can create a moist environment prone to fungal infections. Using a heating pad (choice C) can lead to burns or injuries due to reduced sensation common in diabetes. Soaking feet in warm water daily (choice D) can also increase the risk of skin breakdown and should be avoided.

3. A postpartum complication a client is at risk for is deep-vein thrombosis. Which of the following factors is strongly associated with this postpartum complication?

• A. Cesarean birth
• B. Vaginal birth
• C. Anemia
• D. Multiparity

Correct answer: A

Rationale: The correct answer is A: Cesarean birth. Cesarean birth doubles the risk for deep-vein thrombosis (DVT) due to immobility and vascular changes associated with surgery. Other risk factors for DVT include smoking, obesity, and a history of thromboembolism. Vaginal birth, anemia, and multiparity are not strongly associated with an increased risk of deep-vein thrombosis postpartum. It is important to educate clients undergoing cesarean birth about the increased risk of DVT and measures to prevent it, such as early ambulation and the use of compression stockings.

4. A healthcare provider is assessing a client with chronic obstructive pulmonary disease (COPD). Which of the following findings should the healthcare provider expect?

• A. Decreased respiratory rate
• B. Use of accessory muscles
• C. Improved lung sounds
• D. Increased energy levels

Correct answer: B

Rationale: The correct answer is B: 'Use of accessory muscles.' Clients with COPD often experience airway obstruction, leading to the use of accessory muscles to breathe. This compensatory mechanism helps them overcome the increased work of breathing. Choice A, 'Decreased respiratory rate,' is incorrect because clients with COPD typically have an increased respiratory rate due to the need for more effort to breathe. Choice C, 'Improved lung sounds,' is incorrect because COPD is characterized by wheezes, crackles, and diminished breath sounds. Choice D, 'Increased energy levels,' is incorrect because clients with COPD often experience fatigue due to the increased work of breathing and impaired gas exchange.

5. A client receiving IV moderate (conscious) sedation with midazolam has a respiratory rate of 9/min and is not responding to commands. Which of the following is an appropriate action by the nurse?

• A. Place the client in a prone position
• B. Implement positive pressure ventilation
• C. Perform nasopharyngeal suctioning
• D. Administer flumazenil

Correct answer: D

Rationale: In this scenario, the client is showing signs of respiratory depression and central nervous system depression due to midazolam sedation. Administering flumazenil is the correct action as it is the antidote for midazolam, a benzodiazepine, and can reverse the sedative effects to restore respiratory function. Placing the client in a prone position (choice A) may worsen respiratory compromise. Implementing positive pressure ventilation (choice B) is not the first-line intervention for sedation-related respiratory depression. Performing nasopharyngeal suctioning (choice C) is not indicated as there are no signs of airway obstruction requiring suctioning.

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