Nursing Elites

1. A client with a history of alcoholism is admitted with confusion and ataxia. The LPN/LVN recognizes that these symptoms may be related to a deficiency in which vitamin?

• A. Vitamin A
• B. Vitamin C
• C. Vitamin D
• D. Vitamin B1 (Thiamine)

Correct answer: D

Rationale: The correct answer is Vitamin B1 (Thiamine). Vitamin B1 deficiency, also known as Thiamine deficiency, is common in clients with a history of alcoholism. Thiamine is essential for proper brain function, and its deficiency can lead to neurological symptoms such as confusion and ataxia. Vitamin A, C, and D deficiencies do not typically present with confusion and ataxia in the context of alcoholism. Vitamin A deficiency mainly affects vision, Vitamin C deficiency leads to scurvy with symptoms like bleeding gums, and Vitamin D deficiency is associated with bone disorders. Therefore, they are not the correct choices in this scenario.

2. A client with cardiovascular disease is being taught by a nurse how to reduce sodium and cholesterol intake. The nurse understands that the most significant factor in planning dietary changes for this client is:

• A. Client’s financial resources
• B. Involvement of the client in planning the change
• C. Availability of low-sodium foods
• D. Frequency of dietary counseling sessions

Correct answer: B

Rationale: The most significant factor in planning dietary changes for a client with cardiovascular disease is the involvement of the client in planning the change. By involving the client in the planning process, the nurse ensures that the client takes ownership of their health and is more likely to adhere to and succeed in modifying dietary habits. This empowerment and engagement enhance the client's motivation and commitment to making sustainable changes. Financial resources, availability of low-sodium foods, and frequency of dietary counseling sessions are important considerations but are not as crucial as the client's active involvement in the planning process.

3. After repositioning a client who reports shortness of breath, which of the following actions should the nurse take next?

• A. Observe the rate, depth, and character of the client's respirations.
• B. Take the client’s blood pressure.
• C. Assess the client's pulse.
• D. Offer supplemental oxygen.

Correct answer: A

Rationale: Observing the rate, depth, and character of the client's respirations is crucial after repositioning a client experiencing shortness of breath. This action provides immediate information about the client's respiratory status. Checking blood pressure (Choice B) is not the priority in this situation, as assessing respirations is more urgent. Assessing the pulse (Choice C) is also important but does not provide direct information about the client's respiratory status. Offering supplemental oxygen (Choice D) may be necessary based on the assessment of respirations, but it should not be the first action taken without assessing the client's breathing pattern.

4. A client is expressing anger over his diagnosis of colorectal cancer. Which of the following actions should the nurse take?

• A. Discuss the risk factors for colorectal cancer.
• B. Focus teaching on addressing the client's anger and emotional response.
• C. Provide the client with emotional support and reassurance about his feelings.
• D. Reassure the client that this is an expected response to grief.

Correct answer: D

Rationale: The correct answer is D. During the anger stage of grief, it is essential for the nurse to reassure the client that anger is a normal reaction to a cancer diagnosis. This validation of the client's emotions can help in providing emotional support. Choice A is incorrect because discussing risk factors for colorectal cancer does not address the client's current emotional state. Choice B is incorrect because focusing teaching on the client's future management does not directly address the client's need for emotional support in the present. Choice C is incorrect because providing written information about loss and grief phases is not as immediately comforting as directly reassuring the client about his feelings of anger.

5. During passive range of motion (ROM) exercises, how should the nurse perform each movement for a patient with impaired mobility?

• A. The nurse moves each movement just to the point of resistance.
• B. The patient repeats each movement 5 times.
• C. The movement continues until the patient reports pain.
• D. The nurse completes each movement quickly and smoothly.

Correct answer: A

Rationale: During passive range of motion (ROM) exercises, the nurse is responsible for moving the patient's joints through their range of motion. The correct technique involves performing movements slowly and smoothly, only going to the point of resistance without causing pain. This technique helps maintain joint flexibility and prevent contractures. Choice A is the correct answer as it reflects the appropriate technique for passive ROM exercises. Choices B and C are incorrect because the patient is not actively participating, and ROM exercises should not cause pain. Choice D is incorrect as movements should be done deliberately and not quickly.

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