Nursing Elites

1. A client with schizophrenia is pacing the hall and is agitated. Which of the following actions should the nurse take?

• A. Ask the client if they intend to harm others.
• B. Tell the client to stop pacing the hall.
• C. Allow the client to pace alone until they feel less anxious.
• D. Walk with the client at a gradually slower pace.

Correct answer: D

Rationale: The correct action for the nurse to take when caring for a client with schizophrenia who is pacing the hall and agitated is to walk with the client at a gradually slower pace. This approach can help reduce the client's agitation and prevent the situation from escalating. Choice A is incorrect because directly asking about harm may increase the client's anxiety. Choice B is inappropriate as it may worsen the client's agitation. Choice C is not recommended as the client may benefit from the nurse's presence and support during this time of distress.

2. A client who has a new diagnosis of hypertension is being taught about dietary modifications by a nurse. Which of the following instructions should the nurse include?

• A. Limit fluid intake to 2 liters per day.
• B. Increase your intake of whole grains.
• C. Eat 3 large meals daily.
• D. Consume foods high in potassium.

Correct answer: B

Rationale: The correct answer is B: 'Increase your intake of whole grains.' Whole grains are beneficial for individuals with hypertension as they can help promote heart health. Whole grains are high in fiber, which can help lower blood pressure. Option A is incorrect as fluid intake should be adequate but not restricted to 2 liters per day. Option C is incorrect as it is recommended to have smaller, more frequent meals rather than 3 large meals to help manage hypertension. Option D is incorrect; although foods high in potassium can be beneficial for hypertension, the most appropriate dietary modification to include in this scenario is increasing whole grain intake.

3. A nurse is reviewing the laboratory results for a client who has Cushing's disease. The nurse should expect the client to have an increase in which of the following laboratory values?

• A. Serum glucose level.
• B. Serum calcium level.
• C. Lymphocyte count.
• D. Serum potassium level.

Correct answer: A

Rationale: The correct answer is A: Serum glucose level. In Cushing's disease, elevated cortisol levels lead to increased gluconeogenesis, insulin resistance, and breakdown of proteins and fats, resulting in elevated blood glucose levels. This is known as hyperglycemia. The other options, including serum calcium level (choice B), lymphocyte count (choice C), and serum potassium level (choice D), are not typically affected by Cushing's disease. Therefore, they are incorrect choices.

4. A nurse is assessing a client who is receiving total parenteral nutrition (TPN). Which of the following findings should the nurse report to the provider?

• A. Blood glucose of 110 mg/dL.
• B. Weight loss of 0.5 kg (1.1 lb) in 24 hours.
• C. WBC count of 6,500/mm3.
• D. Temperature of 37.3°C (99.1°F).

Correct answer: B

Rationale: A weight loss of 0.5 kg (1.1 lb) in 24 hours may indicate dehydration or malnutrition, which are critical concerns for a client receiving total parenteral nutrition (TPN). Therefore, the nurse should report this finding to the provider. Elevated blood glucose levels (Choice A) can be managed by adjusting TPN components, WBC count (Choice C) and a slightly elevated temperature (Choice D) are not directly related to TPN administration and may not require immediate intervention.

5. A nurse is providing teaching to a client who has a new prescription for atorvastatin. Which of the following instructions should the nurse include?

• A. Avoid drinking grapefruit juice while taking this medication.
• B. Take this medication with food to prevent stomach upset.
• C. You should take this medication at bedtime.
• D. You should take this medication on an empty stomach.

Correct answer: A

Rationale: The correct answer is A: 'Avoid drinking grapefruit juice while taking this medication.' Grapefruit juice can increase the risk of toxicity when taken with atorvastatin. Choice B is incorrect because atorvastatin should be taken without regard to meals. Choice C is incorrect because atorvastatin can be taken at any time of the day. Choice D is incorrect because atorvastatin does not need to be taken on an empty stomach.

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