Nursing Elites

1. A nurse is assessing a client who is at risk for falls. Which of the following findings should the nurse recognize as increasing the client's risk of falling?

• A. Normal gait
• B. Recent history of dizziness
• C. 20/20 vision
• D. Takes a multivitamin daily

Correct answer: B

Rationale: The correct answer is B: Recent history of dizziness. A recent history of dizziness significantly increases the risk of falling, as dizziness can impair balance and coordination. Having a normal gait (choice A) and 20/20 vision (choice C) are not factors that directly increase the risk of falling. Taking a multivitamin daily (choice D) does not inherently contribute to an increased risk of falling unless it causes dizziness as a side effect, which is not specified in the question.

2. A client in the second trimester of pregnancy asks how to treat constipation. Which of the following should the nurse recommend?

• A. Decrease intake of vitamins and supplements to every other day
• B. Eat 15 g of fiber per day
• C. Consume 48 ounces of water daily
• D. Drink hot water with lemon juice each morning

Correct answer: D

Rationale: The correct answer is D: Drink hot water with lemon juice each morning. Drinking hot water with lemon juice can help stimulate bowel movements, making it a natural and safe recommendation for pregnant clients experiencing constipation. Choice A is incorrect because reducing vitamin and supplement intake may not directly address constipation. Choice B, eating 15 g of fiber per day, could be helpful but may not be as effective as the correct answer for immediate relief. Choice C, consuming 48 ounces of water daily, is essential for overall health but may not be as directly effective as the correct answer in alleviating constipation.

3. A nurse is caring for a client who has a urinary tract infection (UTI) and is prescribed ciprofloxacin. Which of the following client statements indicates a need for further teaching?

• A. I will stop taking the medication when I feel better.
• B. I will avoid caffeine while taking this medication.
• C. I will wear sunscreen when going outside.
• D. I will drink plenty of fluids while on this medication.

Correct answer: A

Rationale: Clients should be instructed to complete the entire course of antibiotics, even if they start feeling better, to prevent antibiotic resistance and recurrence of infection.

4. A newborn demonstrates respiratory distress, and routine suctioning with the bulb syringe is unsuccessful. What is the next nursing intervention?

• A. Initiate chest compressions
• B. Administer oxygen
• C. Suction with a mechanical device
• D. Notify the healthcare provider

Correct answer: C

Rationale: When routine suctioning with a bulb syringe is unsuccessful in a newborn demonstrating respiratory distress, the next appropriate nursing intervention is to suction with a mechanical device. This method ensures effective removal of any airway obstruction. Initiating chest compressions (Choice A) is not indicated in this scenario as the primary concern is airway clearance. Administering oxygen (Choice B) may be necessary, but addressing the airway obstruction should take precedence. Notifying the healthcare provider (Choice D) can be considered after attempting mechanical suction if the newborn's condition does not improve.

5. A nurse is caring for four clients. Which client should the nurse assess first?

• A. A client scheduled to receive chemotherapy for the first time
• B. A client post-appendectomy with diminished bowel sounds
• C. A client with hypothyroidism who is stuporous
• D. A client with burns requiring a sterile dressing change

Correct answer: C

Rationale: The correct answer is C. The client with hypothyroidism who is stuporous should be assessed first as this may indicate a critical condition, possibly related to severe hypothyroidism. Stupor is a state of near-unconsciousness or insensibility, suggesting a decline in neurological function that requires immediate evaluation. Choices A, B, and D do not present with immediate life-threatening conditions that require urgent assessment. While chemotherapy, post-appendectomy complications, and burn care are important, they do not pose the same level of immediate risk as a stuporous client.

Similar Questions