Nursing Elites

1. When caring for a client with a hearing impairment, which of the following actions should the nurse take when speaking with the client?

• A. Speak in a high-pitched voice.
• B. Exaggerate lip movements.
• C. Face the client when speaking.
• D. Use a monotone voice.

Correct answer: C

Rationale: When caring for a client with a hearing impairment, it is essential for the nurse to face the client when speaking. By facing the client, the nurse allows the individual to read lips and see facial expressions, which can significantly improve communication effectiveness. This approach facilitates better understanding and helps the client feel more connected during interactions. Speaking in a high-pitched voice (Choice A) is not recommended as it may distort speech sounds. Exaggerating lip movements (Choice B) can be patronizing and ineffective. Using a monotone voice (Choice D) lacks intonation that helps convey meaning and emotions in speech, making it harder for the client to understand.

2. A client has a new diagnosis of renal calculi, and the nurse is teaching about dietary management. Which of the following statements should the nurse include in the teaching?

• A. You should increase your intake of calcium-rich foods.
• B. You should decrease your intake of calcium-rich foods.
• C. You should increase your intake of sodium-rich foods.
• D. You should decrease your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct answer is to decrease the intake of calcium-rich foods when managing renal calculi. Calcium can contribute to the formation of stones in the kidneys, so reducing its intake can help prevent the development of new calculi and manage existing ones.

3. When planning care for a client with a pressure ulcer, which intervention should the nurse include in the plan?

• A. Massage the reddened area.
• B. Apply a donut-shaped cushion.
• C. Reposition the client every 3 hours.
• D. Use a transparent film dressing.

Correct answer: D

Rationale: The correct intervention for a client with a pressure ulcer is to use a transparent film dressing. This dressing provides a protective barrier against external contaminants while allowing for wound inspection, promoting healing. Massaging the reddened area can cause further damage to the skin and should be avoided. Donut-shaped cushions can increase pressure on the ulcer site rather than alleviate it. Repositioning the client every 2 hours is a preventive measure for pressure ulcers, but once an ulcer has developed, using a transparent film dressing is a more appropriate intervention to facilitate healing and protect the wound site.

4. A client has a new diagnosis of hypothyroidism, and a nurse is providing dietary management education. Which of the following statements should the nurse include in the teaching?

• A. You should increase your intake of iodine-rich foods.
• B. You should decrease your intake of iodine-rich foods.
• C. You should avoid foods that contain lactose.
• D. You should increase your intake of dairy products.

Correct answer: A

Rationale: In hypothyroidism, increasing intake of iodine-rich foods is beneficial as iodine is essential for the production of thyroid hormones. This helps to support thyroid function in individuals with hypothyroidism. Therefore, advising the client to increase their intake of iodine-rich foods aligns with the recommended dietary management for hypothyroidism. Choice B is incorrect because decreasing iodine-rich foods could lead to further deficiency in individuals with hypothyroidism. Choice C is not directly related to hypothyroidism and lactose intolerance is a separate issue. Choice D is incorrect as increasing dairy products is not a specific recommendation for hypothyroidism unless the client has a deficiency of calcium or vitamin D, which should be assessed separately.

5. When should discharge planning begin for a client admitted to a long-term care facility for rehabilitation after a total hip arthroplasty?

• A. One week prior to the client's discharge
• B. Upon the client's admission to the care facility
• C. Once the discharge date is identified
• D. When the client addresses the topic with the nurse

Correct answer: B

Rationale: Discharge planning should begin upon the client's admission to the care facility. This early start allows the healthcare team to conduct assessments, set goals, and coordinate services for a smooth transition back home or to the community. Initiating discharge planning early ensures timely arrangements, leading to optimal outcomes and continuity of care. Choices A, C, and D are incorrect because waiting until one week before discharge, after the discharge date is identified, or until the client brings up the topic may lead to rushed decision-making, inadequate arrangements, and a less effective transition process.

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