Nursing Elites

1. A client has been diagnosed with terminal cancer. Which of the following interventions is a priority?

• A. Teach the client to use progressive relaxation techniques.
• B. Help the client find a local support group.
• C. Discuss the client's prior coping mechanisms.
• D. Develop a list of goals with the client.

Correct answer: D

Rationale: When a client receives a terminal cancer diagnosis, it is crucial to prioritize developing a list of goals with the client. This process helps the client focus on what is important to them, set achievable objectives, and maintain a sense of purpose and control. Teaching relaxation techniques (choice A) may be beneficial for symptom management but is not the priority when confronting a terminal illness. While finding a local support group (choice B) can be valuable for emotional support, it does not directly address setting goals. Discussing prior coping mechanisms (choice C) can provide insights into the client's coping strategies but may not be as essential as establishing future goals in the face of a terminal illness.

2. A 3-year-old child has had multiple tooth extractions while under general anesthesia. The client returns from the post-anesthesia care unit crying but awake. Which approach is likely to be successful?

• A. Examine the mouth first
• B. Reassure the child
• C. Examine the mouth last
• D. Offer a pacifier

Correct answer: C

Rationale: In this scenario, it is crucial to prioritize the comfort of the child. By examining the mouth last, discomfort is minimized, and the child is given the opportunity to settle down. Choosing to examine the mouth first may escalate the distress of the child further. While reassuring the child is important, in this case, addressing the physical discomfort before providing emotional reassurance is more effective. Offering a pacifier may provide some comfort, but addressing the immediate physical discomfort by examining the mouth last is the most appropriate action to help the child settle down after the procedure.

3. The healthcare provider is caring for a client with a history of atrial fibrillation. Which assessment finding would be most concerning?

• A. Blood pressure of 150/90 mmHg
• B. Irregular heart rhythm
• C. Shortness of breath
• D. Fatigue

Correct answer: C

Rationale: Shortness of breath is the most concerning assessment finding in a client with a history of atrial fibrillation. It can indicate a worsening of the condition, pulmonary edema, or the development of a complication such as heart failure. A blood pressure of 150/90 mmHg, while elevated, is not as immediately concerning as respiratory distress in this context. An irregular heart rhythm is expected in atrial fibrillation and may not necessarily be a new or concerning finding. Fatigue is a common symptom in atrial fibrillation but is not as acutely concerning as shortness of breath, which may indicate compromised oxygenation and circulation.

4. The nurse is preparing the teaching plan for a group of parents about risks to toddlers. The nurse plans to explain proper communication in the event of accidental poisoning. The nurse should plan to tell the parents to first state what substance was ingested and then what information should be the priority for the parents to communicate?

• A. The parents' name and telephone number
• B. The currency of the immunization and allergy history of the child
• C. The estimated time of the accidental poisoning and a confirmation that the parents will bring the containers of the ingested substance
• D. The affected child's age and weight

Correct answer: D

Rationale: In the event of accidental poisoning, it is crucial to know the child's age and weight to determine the appropriate treatment. This information helps healthcare providers calculate the correct dosage of antidotes or medications needed based on the child's size and age. The child's age and weight play a significant role in managing accidental poisoning cases. Therefore, this information should be a priority for parents to communicate in such emergencies. Choices A, B, and C are not as critical as the child's age and weight when it comes to immediate treatment decisions for accidental poisoning.

5. A client with asthma is prescribed a corticosteroid inhaler. Which instruction should the nurse provide to the client to prevent a common side effect of this medication?

• A. Use the inhaler only when experiencing asthma symptoms.
• B. Rinse the mouth with water after using the inhaler.
• C. Increase fluid intake while using the inhaler.
• D. Avoid eating or drinking for 30 minutes after using the inhaler.

Correct answer: B

Rationale: The correct instruction for the client using a corticosteroid inhaler to prevent a common side effect is to rinse the mouth with water after using the inhaler. Corticosteroid inhalers can lead to oral thrush, a fungal infection in the mouth. Rinsing the mouth helps reduce the risk of developing oral thrush. Choices A, C, and D are incorrect because using the inhaler only when experiencing symptoms, increasing fluid intake, or avoiding eating/drinking for 30 minutes after use are not directly related to preventing oral thrush, which is the common side effect associated with corticosteroid inhalers.

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