Nursing Elites

1. A client who is at 32 weeks gestation and has a history of cardiac disease is being cared for by a nurse. Which of the following positions should the nurse place the client in to best promote optimal cardiac output?

• A. The chest
• B. Standing
• C. Supine
• D. Left lateral

Correct answer: D

Rationale: The correct answer is the left lateral position. Placing the client in the left lateral position promotes optimal cardiac output during pregnancy by reducing pressure on the inferior vena cava, improving blood flow to the heart and fetus. Choice A, 'The chest,' is incorrect as it does not describe a position that benefits cardiac output. Choice B, 'Standing,' is incorrect as it does not alleviate pressure on the vena cava. Choice C, 'Supine,' is contraindicated in pregnancy, especially in clients with cardiac disease, as it can compress the vena cava and decrease cardiac output.

2. A nurse is sitting with the partner of a client who recently died. Which of the following actions should the nurse take to facilitate mourning?

• A. Encourage the partner to ask for help when needed
• B. Suggest the partner avoid discussing their feelings
• C. Recommend immediate return to daily activities
• D. Advise the partner to remain strong

Correct answer: A

Rationale: The correct action for the nurse to take to facilitate mourning is to encourage the partner to ask for help when needed. Grieving is a challenging process, and offering support and encouragement to seek help can be beneficial. Choice B is incorrect because avoiding discussing feelings can hinder the grieving process by suppressing emotions. Choice C is also incorrect as an immediate return to daily activities may not allow the partner to properly process their grief. Choice D is not the best approach as advising the partner to 'remain strong' may discourage the expression of emotions and seeking support, which are essential in the mourning process.

3. During triage following a mass casualty event, which client should be prioritized?

• A. A client with massive head trauma
• B. A client with full-thickness burns to the face and trunk
• C. A client showing signs of hypovolemic shock
• D. A client with an open fracture of the lower extremity

Correct answer: C

Rationale: During triage after a mass casualty event, the client showing signs of hypovolemic shock should be prioritized. Hypovolemic shock is a life-threatening condition that requires immediate attention to restore circulation and prevent death. While clients with head trauma, burns, and fractures also need urgent care, hypovolemic shock poses an immediate threat to life and must be addressed first to stabilize the client's condition.

4. A nurse is reviewing a client's medical record and notes that the client is taking tamoxifen. The nurse should identify that tamoxifen is used to treat which of the following conditions?

• A. Non-Hodgkin's lymphoma
• B. Endometriosis
• C. Breast cancer
• D. Polycystic ovary syndrome

Correct answer: C

Rationale: Tamoxifen is an anti-estrogen medication primarily used to treat hormone receptor-positive breast cancer. It works by blocking estrogen receptors in breast tissue, slowing the growth of tumors that require estrogen to grow. Choice A, Non-Hodgkin's lymphoma, is incorrect because tamoxifen is not indicated for its treatment. Choice B, Endometriosis, is incorrect as tamoxifen is not used for this condition. Choice D, Polycystic ovary syndrome, is also incorrect since tamoxifen is not a treatment for this syndrome.

5. A nurse in an acute care facility is caring for a client who is postop following abdominal surgery. Which of the following behaviors should the nurse identify as increasing the client's risk for constipation?

• A. Regular fluid intake
• B. Urge suppression
• C. Increased physical activity
• D. Adequate dietary fiber

Correct answer: B

Rationale: Urge suppression can lead to constipation by delaying bowel movements and causing fecal impaction, especially in postoperative patients. Regular fluid intake (choice A) is important to prevent constipation by maintaining hydration and aiding in bowel movements. Increased physical activity (choice C) helps stimulate bowel function and prevent constipation. Adequate dietary fiber (choice D) is essential for promoting healthy bowel movements and preventing constipation. However, urge suppression (choice B) is the behavior that directly contributes to constipation in this scenario.

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