Nursing Elites

1. A male client with angina pectoris is being discharged from the hospital. What instructions should the nurse plan to include in the discharge teaching?

• A. Engage in physical exercise before eating to help decrease cholesterol levels.
• B. Avoid walking briskly in cold weather to prevent a decrease in cardiac output.
• C. Keep nitroglycerin in a light-colored plastic bottle and readily available.
• D. Avoid all isometric exercises, but walk regularly.

Correct answer: C

Rationale: The correct answer is to keep nitroglycerin in a light-colored container and readily available. Nitroglycerin should be protected from light to maintain its effectiveness. Option A is incorrect because physical exercise immediately before eating can trigger angina. Option B is incorrect as cold weather can exacerbate angina symptoms. Option D is incorrect as isometric exercises can increase the workload on the heart, which is not recommended for individuals with angina.

2. The mother of a teenager is told that her son has recently been found stealing from other students at school. The mother's response is, 'I cannot think about that today.' The nurse determines that this mother is using which defense mechanism?

• A. Suppression
• B. Repression
• C. Sublimation
• D. Undoing

Correct answer: A

Rationale: The correct answer is A, Suppression. Suppression involves a conscious effort to avoid dealing with distressing thoughts or feelings. In this case, the mother is consciously choosing not to think about her son's behavior. Choice B, Repression, involves unconsciously blocking out distressing thoughts or feelings. Choice C, Sublimation, is the channeling of unacceptable impulses into socially acceptable behaviors, which is not demonstrated in this scenario. Choice D, Undoing, is a defense mechanism where a person tries to undo or reverse a negative thought or action by performing a contrary behavior, which is not applicable here.

3. An older client comes to the clinic with a family member. When the nurse attempts to take the client’s health history, the client does not respond to questions clearly. What action should the nurse implement first?

• A. Assess the surroundings for noise and distractions
• B. Provide a printed health history form
• C. Defer the health history until the client is less anxious
• D. Ask the family member to answer the questions

Correct answer: A

Rationale: The correct action for the nurse to implement first is to assess the surroundings for noise and distractions. This step is crucial as environmental factors can affect the client's ability to respond clearly. By minimizing noise and distractions, the nurse can create a more conducive environment for effective communication. Providing a printed form (Choice B) may help but addressing environmental factors should come first. Deferring the health history (Choice C) or asking the family member to answer the questions (Choice D) should not be the initial steps, as they do not directly address the issue of unclear communication with the client.

4. The nurse is teaching a class on child care to new parents. Which instruction should be included about the prevention of rotavirus infection in infants who are starting to eat foods?

• A. Keep house pets away from the food preparation area
• B. Avoid feeding infants fresh fruits
• C. Use only lactose-free formulas
• D. Wash hands before any food preparation

Correct answer: D

Rationale: The correct answer is D: Wash hands before any food preparation. Rotavirus is a highly contagious virus that can be prevented by maintaining proper hygiene. Washing hands before handling food can help prevent the spread of infections, including rotavirus. Choices A, B, and C are incorrect because while they are good practices for general hygiene and infant care, they are not specifically targeted at preventing rotavirus infection.

5. An adult client presents to the clinic with large draining ulcers on both lower legs that are characteristic of Kaposi’s Sarcoma lesions. The client is accompanied by two family members. What action should the nurse take?

• A. Obtain a blood sample to determine if the client is HIV positive
• B. Send the family to the waiting area while conducting a head-to-toe assessment
• C. Complete a head-to-toe assessment to identify other signs of HIV
• D. Ask the family members to wear gloves when touching the client

Correct answer: C

Rationale: In this scenario, the most appropriate action for the nurse to take is to complete a head-to-toe assessment to identify other signs of HIV. Kaposi’s Sarcoma is commonly associated with HIV infection, and conducting a comprehensive assessment can provide crucial information on potential signs and symptoms related to HIV. This information is essential for providing appropriate care and treatment. Option A is not the priority at this moment, as the focus should be on assessing the client comprehensively first. Sending the family members away (Option B) may not be necessary if they are not interfering with the assessment process. While infection control is important, asking the family members to wear gloves (Option D) is not the most critical action to take in this situation.

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