Nursing Elites

1. A client with peripheral vascular disease reports leg pain while walking. What intervention is most effective for the nurse to recommend?

• A. Recommend elevating the legs above the heart.
• B. Encourage the client to increase walking distance gradually.
• C. Encourage the client to avoid sitting or standing for long periods.
• D. Instruct the client to use warm compresses for pain relief.

Correct answer: B

Rationale: The correct answer is to encourage the client to increase walking distance gradually. This intervention is effective because gradual increases in walking distance promote circulation, improve oxygen delivery to tissues, and help reduce leg pain caused by peripheral vascular disease. Elevating the legs above the heart (Choice A) may be beneficial in other conditions like venous insufficiency but not specifically for peripheral vascular disease. Encouraging the client to avoid sitting or standing for long periods (Choice C) can help prevent blood pooling but does not directly address the walking-induced leg pain. Instructing the client to use warm compresses for pain relief (Choice D) may provide temporary relief but does not address the underlying circulation issues associated with peripheral vascular disease.

2. A nurse is planning discharge teaching for a client with congestive heart failure (CHF). Which dietary instruction should the nurse provide?

• A. Limit sodium intake to reduce fluid retention
• B. Consume high-protein foods to strengthen the heart
• C. Increase potassium intake to manage blood pressure
• D. Increase fluid intake to promote hydration

Correct answer: A

Rationale: The correct answer is A: Limit sodium intake to reduce fluid retention. Limiting sodium intake is crucial for managing congestive heart failure (CHF) as it helps reduce fluid retention. Excess fluid retention can worsen CHF by increasing the workload on the heart. Choice B is incorrect because while protein is essential for overall health, it is not directly related to managing CHF. Choice C is incorrect because potassium, although important, is not the primary focus in managing CHF. Choice D is incorrect because increasing fluid intake can exacerbate fluid retention in CHF patients.

3. A client who gave birth 48 hours ago has decided to bottle-feed the infant. The nurse observes that both breasts were swollen, warm, and tender on palpation during the assessment. Which instruction should the nurse provide?

• A. Take warm showers to reduce swelling
• B. Wear a tight-fitting bra for support
• C. Apply ice to the breasts for comfort
• D. Express milk manually to relieve discomfort

Correct answer: C

Rationale: The correct answer is to advise the client to apply ice to the breasts for comfort. Applying ice can help reduce swelling and discomfort associated with engorgement in a woman who is not breastfeeding. Expressing milk manually would stimulate further milk production, which is not desired in this case. Wearing a tight bra could increase discomfort by putting pressure on the engorged breasts. Warm showers may actually increase swelling due to the vasodilation effect of heat.

4. A client with diabetes mellitus is prescribed metformin. What teaching should the nurse include?

• A. Take the medication with meals to reduce gastrointestinal upset.
• B. Monitor renal function regularly due to the risk of lactic acidosis.
• C. Avoid alcohol consumption while taking this medication.
• D. Check blood glucose levels regularly to ensure proper management.

Correct answer: B

Rationale: The correct teaching for a client prescribed metformin includes monitoring renal function regularly due to the risk of lactic acidosis, especially in clients with impaired kidney function. While taking metformin with meals can reduce gastrointestinal upset, it is not the highest priority teaching point. Avoiding alcohol is generally recommended but not the most critical teaching point in this scenario. Checking blood glucose levels regularly is important for diabetes management but not specifically related to metformin use.

5. A client asks the nurse for information about reducing risk factors for BPH. Which information should the nurse provide?

• A. Increase physical activity
• B. Decrease alcohol consumption
• C. Reduce intake of dairy products
• D. Avoid caffeine and spicy foods

Correct answer: A

Rationale: The correct answer is A: Increase physical activity. Physical activity can help reduce the risk of benign prostatic hyperplasia (BPH) by improving overall circulation and reducing inflammation. While decreasing alcohol consumption and avoiding caffeine and spicy foods may help with symptom management, increasing physical activity is more strongly linked to the prevention of BPH.

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