Nursing Elites

1. When discussing birth control methods with a client, what major factor should a nurse focus on to provide the motivation needed for consistent implementation of a birth control method?

• A. Personal preference
• B. Work and home schedules
• C. Family planning goals
• D. Desire to have children in the future

Correct answer: A

Rationale: When discussing birth control methods with a client, a nurse should focus on the client's personal preference as a major factor that will provide the motivation needed for consistent implementation of a birth control method. Personal preference plays a key role in ensuring that the chosen method aligns with the client's lifestyle and values, increasing the likelihood of adherence. While work and home schedules, family planning goals, and the desire to have children in the future can influence the choice of birth control method, they are not the primary motivating factors for consistent implementation. Personal preference is crucial as it empowers the client to select a method that suits their individual needs and preferences, ultimately leading to better compliance and effectiveness.

2. Which of the following methods of contraception is able to reduce the transmission of HIV and other STDs?

• A. intrauterine device (IUD)
• B. Norplant
• C. oral contraceptives
• D. vaginal sponge

Correct answer: D

Rationale: The correct answer is the vaginal sponge. The vaginal sponge, when used with foam or jelly contraception, acts as a barrier method that can reduce the transmission of HIV and other STDs, in addition to preventing pregnancy. In contrast, IUDs, Norplant, and oral contraceptives are effective in preventing pregnancy but do not provide protection against the transmission of HIV and STDs. IUDs prevent pregnancy by affecting sperm movement and survival, Norplant releases hormones to prevent ovulation, and oral contraceptives work by inhibiting ovulation. However, these methods do not create a physical barrier against HIV and STD transmission. It is important to counsel clients using methods like IUDs, Norplant, and oral contraceptives to also use chemical or barrier contraceptives to lower the risk of HIV or STD transmission.

3. The LPN is caring for a client taking Lipitor (Atorvastatin). Which of these statements would indicate that the client may need reinforced teaching?

• A. "I take my Lipitor with a glass of milk after my breakfast."?
• B. "I take my Lipitor and wait 30 minutes before taking my other medications."?
• C. "I take my Lipitor 30 minutes after I eat something."?
• D. "I take my Lipitor and my other morning medications with my grapefruit juice at breakfast."?

Correct answer: D

Rationale: The correct answer is, 'I take my Lipitor and my other morning medications with my grapefruit juice at breakfast.' This statement indicates a need for reinforced teaching because grapefruit juice should be avoided when taking Lipitor. Grapefruit juice blocks the enzymes needed to break down the drug, which leads to excessive amounts of the drug in the body. Choices A, B, and C show appropriate timing and administration of Lipitor, whereas choice D poses a potential risk due to the interaction between grapefruit juice and Lipitor.

4. When assessing a client with deep pitting edema, with the indentation remaining for a short time and visible leg swelling, how should a nurse document this finding?

• A. 1+ edema
• B. 2+ edema
• C. 3+ edema
• D. 4+ edema

Correct answer: C

Rationale: The correct answer is 3+ edema. When assessing for edema, the nurse presses thumbs against the ankle malleolus or the tibia. If the skin retains an indentation, it indicates pitting edema. The grading scale for pitting edema includes: 1+ for mild pitting with slight indentation and no perceptible leg swelling, 2+ for moderate pitting where the indentation subsides rapidly, 3+ for deep pitting with an indentation remaining briefly and visible leg swelling, and 4+ for very deep pitting with a long-lasting indentation and significant leg swelling. Choices A, B, and D do not accurately represent the severity of the edema described in the scenario.

5. During a routine health screening, the nurse should talk to the parents of a 1-year-old child about which of the following?

• A. the potential hazards of accidents
• B. appropriate nutrition now that the child has been weaned from breastfeeding
• C. toilet training
• D. how to prevent accidents in the house

Correct answer: A

Rationale: During a routine health screening for a 1-year-old child, discussing the potential hazards of accidents is crucial. Accidents are the primary source of injury in children and can be life-threatening. Addressing appropriate nutrition now that the child has been weaned from breastfeeding should have already been discussed. Toilet training is important but is typically addressed at a later age as one year is too early for this milestone. While preventing accidents in the house is important, focusing on the potential hazards of accidents in general is more comprehensive and critical for the child's safety.

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