Nursing Elites

1. A nurse is caring for a client with Alzheimer's disease. Which action should the nurse include in the care plan to support the client’s cognitive function?

• A. Place a daily calendar in the kitchen
• B. Replace buttoned clothing with zippered items
• C. Replace carpet with hardwood floors
• D. Create variation in the daily routine

Correct answer: A

Rationale: Placing a daily calendar in the kitchen is beneficial for clients with Alzheimer's disease as it helps in orienting them to time and enhances cognitive function. This visual aid can assist in keeping track of days and activities. Choice B, replacing buttoned clothing with zippered items, is more related to promoting independence in dressing rather than directly supporting cognitive function. Choice C, replacing carpet with hardwood floors, focuses on safety and mobility rather than cognitive function. Choice D, creating variation in the daily routine, may be helpful for engagement and stimulation but does not directly address cognitive function as effectively as using a daily calendar.

2. While assessing the IV infusion site of a client who reports pain at the site, a nurse notes redness and warmth along the vein. What should the nurse do?

• A. Continue the infusion
• B. Increase the infusion rate
• C. Discontinue the infusion
• D. Apply a cold compress

Correct answer: C

Rationale: The symptoms described indicate phlebitis, which is inflammation of the vein. In this case, the nurse should discontinue the infusion to prevent further complications. Continuing the infusion or increasing the rate can exacerbate the condition. Applying a cold compress is not recommended for phlebitis; instead, a warm compress can help alleviate discomfort.

3. A nurse is caring for a client who has a prescription for a narcotic medication. After administering, the nurse is left with an unused portion. What should the nurse do?

• A. Store the unused medication for later use
• B. Discard the medication in a regular trash bin
• C. Discard the medication with another nurse as a witness
• D. Report the unused portion to the provider

Correct answer: C

Rationale: The correct answer is to discard the medication with another nurse as a witness. Controlled substances, such as narcotic medications, must be properly disposed of to prevent misuse or diversion. Having another nurse witness the disposal ensures accountability and follows proper protocols. Storing the unused medication for later use (Choice A) is unsafe and could lead to misuse. Discarding the medication in a regular trash bin (Choice B) is inappropriate as it does not ensure proper disposal of a controlled substance. Reporting the unused portion to the provider (Choice D) is not the immediate action needed for proper medication disposal.

4. A nurse is reviewing the medication class, benzodiazepines. The nurse would use caution when administering benzodiazepines to which of the clients below?

• A. A client with glaucoma
• B. A client with renal failure
• C. A client with hypertension
• D. A client with insomnia

Correct answer: A

Rationale: Benzodiazepines can increase intraocular pressure, which is why they must be used cautiously in patients with glaucoma. In clients with this condition, benzodiazepines can potentially worsen symptoms and lead to further complications involving the eyes. Therefore, administering benzodiazepines to a client with glaucoma should be done with caution. Choices B, C, and D are not directly contraindicated with benzodiazepines, making them less likely to cause harm compared to administering to a client with glaucoma.

5. A nurse is planning care for a client who has a new diagnosis of deep vein thrombosis (DVT). Which action should the nurse take?

• A. Massage the affected extremity
• B. Elevate the affected leg
• C. Apply cold packs to the affected leg
• D. Keep the leg dependent to increase circulation

Correct answer: B

Rationale: Elevating the leg promotes venous return and reduces swelling, which is crucial for clients with DVT. Massaging the affected extremity can dislodge the clot and worsen the condition. Applying cold packs can cause vasoconstriction, potentially increasing the risk of clot formation. Keeping the leg dependent can impede circulation and increase the risk of clot migration.

Similar Questions