Nursing Elites

1. A nurse is assessing a client with a history of heart failure. Which of the following findings should the nurse monitor?

• A. Increased energy
• B. Peripheral edema
• C. Elevated heart rate
• D. Improved lung sounds

Correct answer: B

Rationale: The correct answer is B: Peripheral edema. In heart failure, the heart's inability to pump effectively can lead to fluid backup, causing swelling in the extremities, known as peripheral edema. Monitoring for peripheral edema is crucial as it is a common sign of worsening heart failure. Choices A, C, and D are incorrect because increased energy, elevated heart rate, and improved lung sounds are not typical findings in heart failure. Increased energy is not usually associated with heart failure, an elevated heart rate may occur as a compensatory mechanism but is not a direct sign of heart failure, and improved lung sounds are not expected in heart failure which often presents with crackles or wheezes due to pulmonary congestion.

2. A nurse is reviewing a prescription for doxazosin with a client. Which instruction should the nurse include?

• A. Decrease caloric intake to reduce weight gain
• B. Increase dietary fiber to prevent constipation
• C. Rise slowly when sitting up
• D. Take this medication each morning

Correct answer: C

Rationale: The correct answer is C: 'Rise slowly when sitting up.' Doxazosin can cause orthostatic hypotension, a sudden drop in blood pressure when standing up, leading to dizziness or fainting. Instructing the client to rise slowly helps prevent this adverse effect. Choices A, B, and D are incorrect. A decrease in caloric intake to reduce weight gain, an increase in dietary fiber to prevent constipation, and taking the medication each morning are not specific instructions related to managing the side effects of doxazosin.

3. A nurse should teach which of the following clients requiring crutches about how to use a three-point gait?

• A. A client who is able to bear full weight on both lower extremities.
• B. A client who has bilateral leg braces due to paralysis of the lower extremities.
• C. A client who has a right femur fracture with no weight bearing on the affected leg.
• D. A client who has bilateral knee replacements with partial weight bearing on both legs.

Correct answer: C

Rationale: The correct answer is C because a three-point gait is used when the client can bear full weight on one foot and uses crutches and the uninvolved leg to ambulate. Choices A, B, and D are incorrect because they do not meet the criteria for using a three-point gait. Choice A states that the client can bear full weight on both lower extremities, which does not require a three-point gait. Choice B mentions bilateral leg braces due to paralysis, which would not involve using a three-point gait. Choice D describes a client with bilateral knee replacements with partial weight bearing, which also does not align with the use of a three-point gait.

4. A client with cholecystitis has been prescribed a low-fat diet. Which of the following meal selections by the client indicates understanding of the education?

• A. Roast beef with gravy, mashed potatoes, ice cream
• B. Macaroni and cheese, salad, pudding
• C. Creamed chicken on a roll with peas
• D. Roast turkey, rice pilaf, green beans

Correct answer: D

Rationale: The correct answer is D. Roast turkey is a lean protein option suitable for a low-fat diet. Rice pilaf and green beans are also low in fat. Choices A, B, and C contain high-fat ingredients like gravy, cheese, cream, and ice cream, which are not suitable for a low-fat diet.

5. A nurse is teaching a client who is lactose intolerant about dietary choices. Which food should the nurse recommend to increase calcium intake?

• A. Spinach
• B. Peanut butter
• C. Ground beef
• D. Carrots

Correct answer: A

Rationale: The correct answer is A: Spinach. Spinach is rich in calcium, making it a suitable choice for individuals with lactose intolerance who need to avoid dairy products. Peanut butter, ground beef, and carrots are not significant sources of calcium compared to spinach, and therefore, not the best recommendation for increasing calcium intake in lactose-intolerant individuals.

Similar Questions