Nursing Elites

1. A client with a history of heart failure is admitted with weight gain and peripheral edema. Which medication should the LPN/LVN anticipate being prescribed?

• A. Lisinopril (Zestril)
• B. Furosemide (Lasix)
• C. Metoprolol (Lopressor)
• D. Simvastatin (Zocor)

Correct answer: B

Rationale: Furosemide (Lasix) is the correct answer. In a client with heart failure experiencing weight gain and peripheral edema, the priority is to manage fluid overload. Furosemide is a loop diuretic commonly prescribed to reduce excess fluid in heart failure patients. Lisinopril (Zestril) is an ACE inhibitor used to treat hypertension and heart failure but does not directly address fluid overload. Metoprolol (Lopressor) is a beta-blocker that helps manage heart failure symptoms but does not primarily target fluid retention. Simvastatin (Zocor) is a statin used to lower cholesterol levels and is not indicated for managing fluid overload in heart failure.

2. While ambulating an unsteady client who begins to fall, which of the following actions should the nurse take?

• A. Allow the client to slide down their outstretched leg.
• B. Place their arms around the client to prevent the fall.
• C. Remain upright as the client falls toward them.
• D. Move quickly to a position in front of the client.

Correct answer: A

Rationale: When a client is falling, allowing them to slide down your leg can help control the descent and prevent injury. This technique ensures a more controlled fall compared to attempting to catch or stop the client abruptly, which could lead to both the client and the nurse getting injured. Placing arms around the client may not provide enough support or control during the fall. Remaining upright or moving quickly in front of the client might not be practical or safe in this scenario.

3. A client is admitted to a voluntary hospital mental health unit due to suicidal ideation. The client has been on the unit for 2 days and now states, 'I demand to be released now!' The appropriate action is for the nurse to:

• A. You cannot be released because you are still suicidal.
• B. You can be released only if you sign a no-suicide contract.
• C. Let's discuss your decision to leave and then we can prepare you for discharge.
• D. You have a right to sign out as soon as we get an order from the healthcare provider's discharge order.

Correct answer: C

Rationale: The correct action for the nurse in this scenario is to engage the client in a discussion about their decision to leave and then prepare them for discharge. This approach allows the nurse to assess the client's current state, address concerns, and plan for a safe discharge. Option A is incorrect because it does not involve a therapeutic communication approach and may escalate the situation. Option B is incorrect as it places a condition on the client for release, which is not recommended in this situation. Option D is incorrect as it does not prioritize the client's autonomy and right to make decisions about their care.

4. What action should the LPN/LVN take to prevent postoperative complications in a client who has undergone abdominal surgery?

• A. Encourage the client to use an incentive spirometer regularly.
• B. Assist the client in ambulating as soon as possible.
• C. Position the client in high Fowler's position.
• D. Encourage the client to cough and deep breathe regularly.

Correct answer: A

Rationale: Encouraging the client to use an incentive spirometer regularly is crucial in preventing postoperative complications after abdominal surgery. This action helps prevent atelectasis by promoting lung expansion and improving air exchange in the lungs, reducing the risk of respiratory complications. Assisting the client in ambulating early is important for preventing issues like deep vein thrombosis but may not directly address respiratory concerns postoperatively. Positioning the client in high Fowler's position can help with respiratory distress but is not as specific to preventing postoperative respiratory complications as using an incentive spirometer. While encouraging the client to cough and deep breathe is generally beneficial for lung expansion, using an incentive spirometer is more effective and targeted in preventing atelectasis after abdominal surgery.

5. A healthcare professional is assessing a client’s oculomotor nerve functions. Which of the following actions should the healthcare professional take?

• A. Check the client’s pupillary reaction to light
• B. Ask the client to read print from the Snellen chart
• C. Ask the client to identify different scents
• D. Use cotton to lightly touch the client’s cornea

Correct answer: A

Rationale: Checking the client’s pupillary reaction to light is a key assessment to evaluate the oculomotor nerve function. The oculomotor nerve controls the pupil's constriction response to light. Choices B, C, and D are incorrect because testing vision with a Snellen chart, identifying scents, or touching the cornea are not specific assessments for oculomotor nerve function.

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