Nursing Elites

1. A nurse is caring for a client who has a new diagnosis of hypercholesterolemia. Which of the following dietary recommendations should the nurse make?

• A. Increase intake of red meat
• B. Consume foods high in saturated fats
• C. Choose foods low in trans fats
• D. Limit intake of vegetables and fruits

Correct answer: C

Rationale: The correct answer is C: 'Choose foods low in trans fats.' Trans fats are known to increase cholesterol levels, so avoiding foods high in trans fats is essential in managing hypercholesterolemia. Option A, increasing intake of red meat, and option B, consuming foods high in saturated fats, can worsen cholesterol levels as they are sources of unhealthy fats. Option D, limiting intake of vegetables and fruits, is incorrect as they are part of a heart-healthy diet and should be encouraged for individuals with hypercholesterolemia.

2. A client has a new prescription for levothyroxine. Which of the following statements should the nurse include?

• A. Take this medication with food to prevent nausea.
• B. Take this medication in the morning to prevent insomnia.
• C. You should store this medication in the refrigerator.
• D. Take this medication with a full glass of water before breakfast.

Correct answer: D

Rationale: The correct statement the nurse should include is to take levothyroxine with a full glass of water before breakfast. This helps improve absorption and prevents gastrointestinal side effects. Choice A is incorrect because levothyroxine should be taken on an empty stomach. Choice B is incorrect as insomnia is not a common side effect of levothyroxine. Choice C is also incorrect as levothyroxine does not need to be refrigerated.

3. A client has a new prescription for furosemide. Which of the following instructions should the nurse include?

• A. Avoid consuming dairy products.
• B. Increase your intake of potassium-rich foods.
• C. Limit fluid intake to prevent dehydration.
• D. Take the medication at bedtime.

Correct answer: B

Rationale: The correct answer is to instruct the client to increase their intake of potassium-rich foods when taking furosemide. Furosemide is a loop diuretic that can cause potassium loss, so consuming potassium-rich foods like bananas and oranges can help maintain adequate potassium levels. Choice A is incorrect because there is no need to avoid consuming dairy products. Choice C is incorrect because while fluid intake may need to be monitored, the general instruction is not to limit fluids to prevent dehydration. Choice D is incorrect because furosemide is usually best taken during the day to avoid disrupting sleep with frequent urination.

4. A nurse is preparing to administer heparin subcutaneously to a client. Which of the following actions should the nurse take?

• A. Use a 21-gauge needle for injection.
• B. Inject the medication into the client's deltoid muscle.
• C. Administer the medication within 5 cm (2 in) of the umbilicus.
• D. Massage the injection site after administration.

Correct answer: C

Rationale: The correct action the nurse should take when preparing to administer heparin subcutaneously is to administer the medication within 5 cm (2 in) of the umbilicus. This practice ensures proper subcutaneous delivery of the medication. Choice A is incorrect because a smaller gauge needle, typically 25-26 gauge, is used for subcutaneous injections. Choice B is incorrect as heparin should not be injected into the deltoid muscle but rather into fatty tissue. Choice D is incorrect as massaging the injection site after administration can lead to tissue irritation or bruising.

5. A client with a new diagnosis of diabetes mellitus is being taught about foot care by a nurse. Which of the following instructions should the nurse include?

• A. Soak your feet in warm water every day to prevent dryness.
• B. Trim your toenails straight across to prevent injury.
• C. Apply lotion between your toes after bathing.
• D. Wear cotton socks to keep your feet dry.

Correct answer: B

Rationale: The correct answer is B: 'Trim your toenails straight across to prevent injury.' In clients with diabetes, trimming toenails straight across is essential to prevent ingrown toenails and injury. Choice A is incorrect because soaking feet in warm water can lead to dryness, which is not recommended for diabetic foot care. Choice C is incorrect as applying lotion between the toes can create excess moisture, increasing the risk of fungal infections. Choice D is incorrect because although cotton socks are recommended, the primary purpose is to prevent moisture buildup, not specifically to keep the feet dry.

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