Nursing Elites

1. A nurse is educating a client about caloric intake and weight reduction. Which of the following client statements indicates an understanding of the teaching?

• A. If I eat 500 fewer calories per day, I should lose 1 pound per week.
• B. If I eat 450 fewer calories per day, I should lose 2 pounds per week.
• C. If I eat 250 fewer calories per day, I should lose 2 pounds per week.
• D. If I eat 300 fewer calories per day, I should lose 1 pound per week.

Correct answer: A

Rationale: The correct answer is A: 'If I eat 500 fewer calories per day, I should lose 1 pound per week.' This statement is accurate because a reduction of 500 calories per day typically results in a weight loss of 1 pound per week. This is based on the principle that a calorie deficit of 3,500 calories equals about 1 pound of body fat. Choices B, C, and D are incorrect because they do not align with the established relationship between calorie reduction and weight loss. Eating 450 fewer calories per day would not lead to a weight loss of 2 pounds per week; similarly, reducing calories by 250 or 300 per day would not result in losing 2 pounds or 1 pound per week, respectively.

2. A nurse enters a client's room and sees smoke coming from the trash can. Which of the following actions should the nurse take first?

• A. Close the window
• B. Evacuate the room
• C. Call the fire department
• D. Attempt to extinguish the fire

Correct answer: B

Rationale: The correct answer is to evacuate the room first. In a fire situation, the priority is safety, following the RACE protocol: Rescue, Alarm, Contain, Extinguish. Evacuating the room ensures the safety of both the client and the nurse. Closing the window (Choice A) can wait until after evacuation when there is no immediate danger. Calling the fire department (Choice C) is important but comes after ensuring personal safety and evacuating. Attempting to extinguish the fire (Choice D) is not recommended as it can put the nurse and the client at risk; firefighting should be left to professionals.

3. A nurse is caring for a postmenopausal client prescribed the aromatase inhibitor anastrozole for the treatment of breast cancer. Which of the following should the nurse inform the client she may experience?

• A. Weight gain
• B. Muscle and joint pain
• C. Night sweats
• D. Increased appetite

Correct answer: B

Rationale: The correct answer is B: Muscle and joint pain. Muscle and joint pain are common side effects of aromatase inhibitors like anastrozole. These side effects can be managed with analgesics as prescribed by the healthcare provider. Weight gain (choice A) is not typically associated with anastrozole. Night sweats (choice C) are also not commonly reported with this medication. Increased appetite (choice D) is not a common side effect of anastrozole.

4. An antepartum client is Rh negative and understands that she will receive a RhoGAM injection during her pregnancy. The client asks the nurse if she will also receive a RhoGAM injection after the birth of her baby. The client will receive RhoGAM after the birth if blood tests are:

• A. Mother Rh positive; baby Rh negative
• B. Mother Rh negative; Coombs positive; baby Rh negative
• C. Mother Rh positive; Coombs negative; baby Rh positive
• D. Mother Rh negative; Coombs negative; baby Rh positive

Correct answer: D

Rationale: The correct answer is D. If the baby is Rh positive and the mother is Rh negative, the mother may develop antibodies against the baby's blood. RhoGAM is administered to prevent the mother's immune system from becoming sensitized to Rh-positive blood. Therefore, the mother, who is Rh negative, will receive RhoGAM after birth if the baby is Rh positive and both the mother and baby have negative Coombs tests. Choices A, B, and C are incorrect because they do not match the criteria for RhoGAM administration in this scenario.

5. A nurse is assessing a client diagnosed with schizophrenia. The nurse asks the client to interpret the following statement: “When the cat’s away, the mice will play.” The client responds, “The mice come out when the cat is not around.” The nurse should document this finding as:

• A. Echolalia
• B. Associative looseness
• C. Neologisms
• D. Concrete thinking

Correct answer: D

Rationale: The client’s literal interpretation of the statement is an example of concrete thinking, a cognitive symptom often seen in schizophrenia where abstract thinking is impaired. Choice A, Echolalia, is the repetition of words spoken by others, which is not demonstrated in this scenario. Choice B, Associative looseness, refers to a disturbance in the logical progression of thoughts, leading to a disorganized thought process. Choice C, Neologisms, involves creating new words or phrases with unique meanings, which is not evident in the client's response.

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