Nursing Elites

1. A client with a history of seizures is being discharged home. Which instruction is most important for the nurse to provide?

• A. Take your medication as prescribed.
• B. Avoid driving until your condition is stable.
• C. Keep a seizure diary.
• D. Avoid alcohol consumption.

Correct answer: A

Rationale: The most important instruction for a client with a history of seizures being discharged home is to take their medication as prescribed. Consistent and timely intake of anti-seizure medication is vital in managing seizures and preventing episodes. While instructions like avoiding driving until the condition is stable, keeping a seizure diary, and avoiding alcohol consumption are important, none are as critical as ensuring proper medication adherence to control seizures effectively. Failure to take prescribed medications can lead to breakthrough seizures, compromising the patient's safety and seizure control.

2. The nurse is caring for a client with a diagnosis of major depressive disorder who has been prescribed a selective serotonin reuptake inhibitor (SSRI). What is the most important teaching point?

• A. Take the medication with food.
• B. Expect to see improvement within 24 hours.
• C. Avoid drinking grapefruit juice.
• D. Report any thoughts of self-harm immediately.

Correct answer: D

Rationale: The correct answer is D: 'Report any thoughts of self-harm immediately.' Clients prescribed SSRIs should be educated to report any thoughts of self-harm promptly, as these medications can initially increase suicidal ideation. Choice A is incorrect because SSRIs are usually taken on an empty stomach. Choice B is incorrect as it takes several weeks for SSRIs to reach their full effectiveness. Choice C is irrelevant to SSRI therapy.

3. A nurse is developing a care plan for a client with chronic pain. What interventions should be included to help manage pain?

• A. Administer pain medication around the clock
• B. Teach relaxation techniques
• C. Encourage physical activity
• D. All of the above

Correct answer: D

Rationale: In managing chronic pain, it is essential to employ a multi-faceted approach. Administering pain medication around the clock helps maintain consistent pain relief. Teaching relaxation techniques such as deep breathing or guided imagery can help reduce muscle tension and promote relaxation, which can alleviate pain. Encouraging physical activity, tailored to the client's abilities, can help improve overall physical functioning and reduce pain perception. Therefore, combining all these interventions (pain medication, relaxation techniques, and physical activity) provides a comprehensive approach to pain management, addressing different aspects of the client's experience with chronic pain. This holistic approach is more effective than using a single intervention alone, making 'All of the above' the correct choice.

4. A client is admitted with a diagnosis of congestive heart failure (CHF). Which intervention is most important to include in the plan of care?

• A. Restrict fluid intake
• B. Provide a high-sodium diet
• C. Encourage vigorous exercise
• D. Administer bronchodilators as prescribed

Correct answer: A

Rationale: The correct answer is A: Restrict fluid intake. Fluid restriction is crucial in the management of congestive heart failure (CHF) as it helps prevent fluid overload, which can exacerbate CHF symptoms. Choices B, C, and D are incorrect. Providing a high-sodium diet would worsen fluid retention and increase the workload of the heart. Encouraging vigorous exercise can strain the heart further in CHF patients. Administering bronchodilators is not the priority intervention for CHF.

5. The client is being taught about managing chronic kidney disease (CKD). Which dietary restriction should be emphasized the most?

• A. Limit consumption of high-fiber foods
• B. Restrict protein intake
• C. Avoid dairy products
• D. Increase fluid intake

Correct answer: B

Rationale: Restricting protein intake is vital in managing chronic kidney disease (CKD) as it helps decrease the kidneys' workload and slows down disease progression. High-fiber foods are generally beneficial for health and should not be limited in CKD management. Dairy products can be consumed moderately unless contraindicated. While adequate fluid intake is crucial, increasing intake excessively may not be suitable for all CKD patients, especially those with fluid restrictions. Therefore, the most crucial dietary restriction to emphasize in CKD management is restricting protein intake.

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