Nursing Elites

1. A nurse in a provider’s office is caring for a client who states, “I always have trouble sleeping.” Which of the following actions should the nurse take first?

• A. Teach the client stress reduction techniques
• B. Recommend that the client avoid caffeine intake in the evening
• C. Identify the client’s typical bedtime routine
• D. Encourage the client to exercise regularly during daytime hours

Correct answer: C

Rationale: The correct action for the nurse to take first is to identify the client’s typical bedtime routine. Understanding the client’s sleep habits, environment, and bedtime rituals can provide valuable insight into potential factors contributing to their sleep troubles. Teaching stress reduction techniques (choice A) may be beneficial but should come after understanding the client's routine. Recommending avoiding caffeine intake in the evening (choice B) and encouraging regular daytime exercise (choice D) are important interventions, but identifying the bedtime routine takes precedence as it directly addresses the client's immediate concern.

2. To evaluate a client's understanding of self-administering insulin within the psychomotor domain of learning, what action should the instructor take?

• A. Have the client demonstrate the procedure.
• B. Explain the procedure again.
• C. Ask the client to describe the procedure.
• D. Observe the client watching a video on the procedure.

Correct answer: A

Rationale: Having the client demonstrate the procedure is the most appropriate action to evaluate understanding within the psychomotor domain of learning. This allows the instructor to assess the client's ability to perform the skill, which is a key aspect of this domain. Choice B, explaining the procedure again, focuses on the cognitive domain rather than the psychomotor domain. Choice C, asking the client to describe the procedure, pertains more to the verbal or cognitive domain of learning. Choice D, observing the client watching a video on the procedure, does not directly assess the client's ability to perform the skill in the psychomotor domain.

3. A client who is terminally ill has a family member who is coping effectively with the situation. Which of the following statements should the nurse identify as an indication of effective coping?

• A. "We still have hope that everything will be okay."
• B. "This is a difficult time, but we are helping each other through this."
• C. "After he comes home, we can plan out a family reunion."
• D. "We don't need to talk about funeral arrangements at this time."

Correct answer: B

Rationale: The correct answer is B because an effective coping strategy involves mutual support and communication within the family. This statement reflects effective coping skills as the family is shown to be helping each other through the difficult time. Choice A is incorrect as maintaining hope does not necessarily indicate effective coping. Choice C focuses on future events and may not address the current situation of coping with a terminally ill family member. Choice D avoids discussing important aspects of end-of-life planning, which may not reflect effective coping with the situation at hand.

4. A healthcare professional is instructing an AP about caring for a client who has a low platelet count. Which of the following instructions is the priority for measuring vital signs for this client?

• A. Avoid measuring the client’s temperature rectally.
• B. Count the client’s radial pulse for 30 seconds and multiply it by 2.
• C. Count the client’s respirations discreetly.
• D. Allow the client to rest for 5 minutes before measuring their BP.

Correct answer: A

Rationale: The correct answer is to avoid measuring the client’s temperature rectally. Rectal temperatures can cause bleeding in clients with low platelet counts. It is crucial to avoid invasive methods that could increase the risk of bleeding or discomfort. Choice B, counting the radial pulse, is not directly related to the risk of bleeding in a client with low platelet count. Choice C, counting respirations discreetly, is important for accuracy but is not the priority when considering the risk of bleeding. Choice D, letting the client rest before measuring blood pressure, is beneficial but is not the priority in preventing potential harm due to low platelet counts.

5. A client is experiencing a severe sore throat, pain when swallowing, and swollen lymph nodes. Which of the following stages of infection is the client likely in?

• A. Prodromal
• B. Incubation
• C. Convalescence
• D. Illness

Correct answer: D

Rationale: The client in this scenario is in the illness stage of infection. During this stage, the individual exhibits specific symptoms such as a severe sore throat, pain when swallowing, and swollen lymph nodes. The prodromal stage precedes the appearance of specific symptoms and is characterized by nonspecific signs. The incubation period occurs between exposure to the pathogen and the onset of symptoms. Convalescence is the recovery period following the resolution of the infection. Therefore, the correct answer is 'D: Illness' as it aligns with the symptoms presented by the client.

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