Nursing Elites

1. A client with multiple sclerosis is receiving baclofen (Lioresal). The nurse should monitor the client for which of the following side effects?

• A. Hypertension
• B. Muscle spasms
• C. Drowsiness
• D. Tachycardia

Correct answer: C

Rationale: The correct answer is C: Drowsiness. Baclofen, a muscle relaxant commonly used to treat conditions like multiple sclerosis, can cause drowsiness as a side effect. Monitoring for drowsiness is important to ensure the client's safety and well-being. Choice A, Hypertension, is incorrect because baclofen is not known to cause hypertension. Choice B, Muscle spasms, is not a common side effect of baclofen but rather the symptom it is used to treat. Choice D, Tachycardia, is also incorrect as baclofen is not associated with causing an increase in heart rate.

2. The RN at a migrant health center notes an increased incidence of dermatitis in seasonal farm workers at a local fruit farm. In response to this finding, what is the most important information for the RN to obtain as part of the community assessment?

• A. Availability of clean fresh water to wash hands after work.
• B. Proper housing
• C. Access to health care services
• D. Access to transportation

Correct answer: A

Rationale: The correct answer is A: Availability of clean fresh water to wash hands after work. Proper hand hygiene, including washing hands with clean water, is crucial in preventing dermatitis, especially in farm workers who are exposed to potential irritants in their work environment. While proper housing (choice B), access to health care services (choice C), and access to transportation (choice D) are important factors in overall community health, they are not directly linked to preventing dermatitis in this scenario.

3. In reviewing the assessment data of a client suspected of having diabetes insipidus, the nurse expects which of the following after a water deprivation test?

• A. Increased edema and weight gain
• B. Unchanged urine specific gravity
• C. Rapid protein excretion
• D. Decreased blood potassium

Correct answer: B

Rationale: After a water deprivation test in a client suspected of having diabetes insipidus, the nurse would expect the urine specific gravity to remain unchanged. This occurs because in diabetes insipidus, the kidneys are unable to concentrate urine, leading to a low urine specific gravity even after water deprivation. Choices A, C, and D are incorrect. Increased edema and weight gain are not typical findings in diabetes insipidus. Rapid protein excretion is not directly related to the condition, and decreased blood potassium is not a common outcome of a water deprivation test for diabetes insipidus.

4. The nurse is teaching a community group about risks of cardiovascular disease. Several clients ask the nurse to determine their risk. Which client should the nurse identify as having the greatest risk for cardiovascular disease?

• A. A male with a serum cholesterol level of 199 mg/dl.
• B. A female with a serum cholesterol level of 201 mg/dl.
• C. A male with a low-density lipoprotein (LDL) level of 200 mg/dl.
• D. A female with a low-density lipoprotein (LDL) level of 160 mg/dl.

Correct answer: C

Rationale: The correct answer is C. A male with a high LDL level (200 mg/dl) has a significant risk for cardiovascular disease. High levels of LDL cholesterol are associated with an increased risk of atherosclerosis and heart disease. Choices A, B, and D have serum cholesterol levels that are slightly elevated but are not as specific or directly linked to cardiovascular risk as high LDL levels. Therefore, the client with the high LDL level is at the greatest risk for cardiovascular disease.

5. A nurse is planning a nutrition class for a group of senior citizens at a community center and wants to emphasize the amount and types of fat in some foods versus others. What is the best teaching method for the nurse to use?

• A. Display posters with foods and inform seniors about fat content.
• B. Determine the foods most often eaten by this group and discuss the nutritional panel of each product.
• C. Show a movie about cooking with foods that are low in fat but delicious.
• D. Ask each senior to bring a food for others to taste, then estimate the fat content in these foods.

Correct answer: B

Rationale: The best teaching method for the nurse in this scenario is to determine the foods most often eaten by the group and discuss the nutritional panel of each product. This approach directly educates the seniors about the fat content in the foods they commonly consume, making the information more relevant and applicable to their daily lives. Choice A, displaying posters with foods, may not engage the seniors effectively or provide detailed information about fat content. Choice C, showing a movie about cooking with low-fat foods, may not address the specific fat content of the seniors' usual food choices. Choice D, asking seniors to bring foods for tasting and estimating fat content, could be subjective and less educational compared to discussing concrete nutritional information from food labels.

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