Nursing Elites

1. A client with hypertension is being seen in a community clinic. The nurse notes that the client has not been taking their prescribed medication regularly. What is the most appropriate initial intervention?

• A. Educate the client on the importance of medication adherence
• B. Explore the reasons for non-adherence with the client
• C. Refer the client to a hypertension specialist
• D. Adjust the client's medication regimen

Correct answer: B

Rationale: The most appropriate initial intervention when a client is not adhering to prescribed medication is to explore the reasons for non-adherence with the client. Understanding the client's perspective can help identify barriers to adherence, such as side effects, cost, forgetfulness, or misunderstanding of the treatment. By addressing these reasons, the nurse can work collaboratively with the client to develop strategies to improve medication compliance. Educating the client on the importance of adherence (Choice A) may be necessary but should come after exploring the reasons for non-adherence. Referring the client to a hypertension specialist (Choice C) or adjusting the medication regimen (Choice D) should be considered after addressing the underlying reasons for non-adherence.

2. An adolescent tells the school nurse that she is pregnant. Her last menstrual period was 4 months ago. She has not received any medical care. She smokes but denies any other substance use. What is the priority nursing action?

• A. notify her parents
• B. refer her for prenatal care
• C. teach breastfeeding methods
• D. offer nutritional instructions

Correct answer: B

Rationale: The correct answer is to refer her for prenatal care. Prenatal care is essential to monitor the health of both the mother and the fetus during pregnancy. While notifying her parents may be important for support and involvement, the priority is ensuring the adolescent receives medical care. Teaching breastfeeding methods and offering nutritional instructions are important but are not the immediate priority in this situation where prenatal care is urgently needed.

3. A community health nurse is evaluating the effectiveness of a diabetes management program. Which outcome indicates that the program is successful?

• A. increased attendance at diabetes education sessions
• B. reduced incidence of diabetes-related hospitalizations
• C. higher rates of blood glucose monitoring among participants
• D. greater knowledge of diabetes management techniques

Correct answer: B

Rationale: The correct answer is B: reduced incidence of diabetes-related hospitalizations. This outcome is a strong indicator of successful diabetes management, as it suggests that participants are effectively controlling their condition and experiencing fewer severe complications that require hospitalization. Increased attendance at education sessions (choice A) may not directly correlate with improved health outcomes. While higher rates of blood glucose monitoring (choice C) are important, they alone may not reflect overall program success. Greater knowledge of diabetes management techniques (choice D) is valuable but does not directly measure the impact of the program on health outcomes like reduced hospitalizations.

4. What is the most important information for a nurse to obtain when an older female client expresses not deserving to eat due to lack of money?

• A. Client's thoughts about wanting to hurt herself
• B. Medication history for antipsychotic agents
• C. Availability of family members to provide meals
• D. Community resources to provide financial aid

Correct answer: A

Rationale: The correct answer is A: Client's thoughts about wanting to hurt herself. When a client expresses not deserving to eat due to lack of money, it raises concerns about her mental and emotional well-being. Assessing for suicidal ideation is crucial in this situation to ensure the client's immediate safety. Options B, C, and D are not the most critical information to obtain in this scenario. While medication history, family support, and community resources are important aspects of care, in this context, the client's mental health and risk of self-harm take precedence.

5. An 80-year-old client is given morphine sulfate for postoperative pain. Which concomitant medication should the nurse question that poses a potential development of urinary retention in this geriatric client?

• A. Nonsteroidal anti-inflammatory agents.
• B. Antihistamines.
• C. Tricyclic antidepressants.
• D. Antibiotics.

Correct answer: C

Rationale: The correct answer is C: Tricyclic antidepressants. Drugs with anticholinergic properties, such as tricyclic antidepressants, can exacerbate urinary retention associated with opioids in older clients. Nonsteroidal anti-inflammatory agents (Choice A) do not typically cause urinary retention. Antihistamines (Choice B) may cause urinary retention but are not the primary concern in this scenario. Antibiotics (Choice D) are not associated with an increased risk of urinary retention compared to tricyclic antidepressants.

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