Nursing Elites

1. A client with rheumatoid arthritis is prescribed methotrexate. What information should the LPN include when teaching the client about this medication?

• A. Avoid exposure to sunlight.
• B. Take the medication with food.
• C. Increase fluid intake while on this medication.
• D. Report any signs of infection to the healthcare provider immediately.

Correct answer: D

Rationale: The correct answer is D: 'Report any signs of infection to the healthcare provider immediately.' Methotrexate is an immunosuppressant medication commonly used to treat rheumatoid arthritis. It can lower the immune system's ability to fight infections, making it crucial for clients to promptly report any signs of infection to prevent serious complications. Choices A, B, and C are incorrect because avoiding sunlight, taking the medication with food, and increasing fluid intake are not specific to methotrexate therapy and are not primary concerns associated with this medication.

2. The provider orders Lanoxin (digoxin) 0.125 mg PO and furosemide 40 mg every day. Which of these foods would the nurse reinforce for the client to eat at least daily?

• A. Spaghetti
• B. Watermelon
• C. Chicken
• D. Tomatoes

Correct answer: B

Rationale: The correct answer is B: Watermelon. Watermelon is high in potassium, which is important to eat daily when taking furosemide to prevent hypokalemia. Furosemide is a diuretic that can lead to potassium loss, so consuming potassium-rich foods like watermelon helps maintain adequate potassium levels. Spaghetti, chicken, and tomatoes are not as high in potassium and therefore not as beneficial in preventing hypokalemia related to furosemide use.

3. A nurse on a medical-surgical unit is receiving a change-of-shift report for four clients. Which of the following clients should the nurse see first?

• A. A client who has new onset of dyspnea 24 hours after a total hip arthroplasty
• B. A client who has acute abdominal pain rated 4 on a scale from 0 to 10
• C. A client who has a UTI and low-grade fever
• D. A client who has pneumonia and an oxygen saturation of 96%

Correct answer: A

Rationale: The nurse should prioritize seeing the client who has new onset dyspnea 24 hours after a total hip arthroplasty first. This sudden dyspnea could indicate a serious complication like a pulmonary embolism, which requires immediate assessment and intervention. Acute abdominal pain, a UTI with a low-grade fever, and pneumonia with an oxygen saturation of 96% are important concerns but are not as immediately life-threatening as potential pulmonary embolism indicated by sudden dyspnea postoperatively.

4. A nurse at a clinic is collecting data about pain from a client who reports severe abdominal pain. The nurse asks the client if there have been any accompanying nausea and vomiting. Which of the following pain characteristics is the nurse attempting to determine?

• A. Presence of associated manifestations.
• B. Location of the pain
• C. Pain quality
• D. Aggravating and relieving factors

Correct answer: A

Rationale: The nurse is identifying associated manifestations like nausea and vomiting that may occur with the pain. The presence of associated manifestations helps in understanding the broader clinical picture and potential causes of the pain. Location refers to where the pain is felt, pain quality describes the nature of the pain, and aggravating and relieving factors relate to what makes the pain worse or better. In this scenario, the focus is on identifying additional symptoms that can provide important diagnostic clues.

5. A nurse enters a client's room and finds her on the floor. The client's roommate reports that the client fell out of bed. Which of the following statements should the nurse document?

• A. “Client found lying on the floor.”
• B. “Client fell out of bed and was found on the floor.”
• C. “Client experienced a fall from the bed.”
• D. “Client was discovered on the floor following a fall from the bed.”

Correct answer: B

Rationale: The correct answer is B. The documentation should be clear and precise, providing details about the context of the fall. Choice A is vague and does not specify the cause of the client being on the floor. Choice C is less specific and does not directly state that the client fell from the bed. Choice D is wordy and less direct compared to option B, which clearly states that the client fell out of bed and was found on the floor.

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