Nursing Elites

1. A nurse is planning care for a client following gastric bypass surgery. The nurse should include which of the following dietary instructions when preparing the client for discharge?

• A. Start each meal with a protein source.
• B. Consume at least 25g of fiber daily.
• C. Check your blood glucose level before each meal.
• D. Limit your meals to three times per day.

Correct answer: A

Rationale: The correct answer is A: 'Start each meal with a protein source.' Protein is crucial for healing and maintaining muscle mass after gastric bypass surgery, making it essential to include in each meal. Choice B is incorrect because immediately after surgery, the focus is typically on a low-fiber diet to aid in healing. Choice C is unrelated to the nutritional needs following gastric bypass surgery. Choice D is also incorrect as patients recovering from gastric bypass surgery may require more frequent, smaller meals to meet their nutritional needs.

2. A nurse has provided education to a client regarding prescribed levothyroxine sodium. Which of the following client statements demonstrates understanding of medication administration?

• A. I should take the medication in the morning to prevent insomnia.
• B. I can take the medication at night before bed.
• C. I will stop the medication if I start to feel better.
• D. I will take the medication only when I feel symptoms.

Correct answer: A

Rationale: The correct answer is A. Levothyroxine should be taken in the morning on an empty stomach to prevent insomnia and ensure proper absorption of the medication. Choice B is incorrect because taking levothyroxine at night may interfere with sleep and absorption. Choice C is incorrect as stopping the medication without consulting the healthcare provider can lead to negative health outcomes. Choice D is incorrect because levothyroxine is a daily medication that should be taken consistently, not just when symptoms are present.

3. A nurse is caring for a client who has a new diagnosis of tuberculosis (TB). The client has a productive cough and is started on airborne precautions. Which of the following interventions should the nurse implement?

• A. Wear an N95 respirator mask when caring for the client.
• B. Place the client in a semi-private room.
• C. Have the client wear a surgical mask during meals.
• D. Use a negative pressure air filtration system.

Correct answer: A

Rationale: The correct answer is to wear an N95 respirator mask when caring for the client with TB. This is crucial to prevent the nurse from inhaling the airborne particles that spread the infection. Choice B is incorrect because placing the client in a semi-private room does not address the protection of the nurse. Choice C is incorrect as having the client wear a surgical mask during meals is not sufficient to protect the nurse during all interactions. Choice D is incorrect as using a negative pressure air filtration system is more applicable to airborne infection isolation rooms in healthcare settings and not a standard intervention for nurses caring for a single client with TB.

4. When educating a client about valproic acid, which instruction is essential?

• A. Monitor for rash
• B. Expect weight loss
• C. Consider it safe during pregnancy
• D. Purchase it over-the-counter

Correct answer: A

Rationale: The correct answer is to instruct the client to monitor for rash. Valproic acid can lead to severe skin rashes, and patients must be vigilant to report any rash promptly. Choice B is incorrect as valproic acid is more likely to cause weight gain. Choice C is incorrect because valproic acid is associated with birth defects and should be avoided during pregnancy. Choice D is incorrect as valproic acid is a prescription medication and not available over-the-counter.

5. A client has been diagnosed with tuberculosis. Which of the following precautions should the nurse initiate to prevent transmission of the disease?

• A. Contact precautions
• B. Airborne precautions
• C. Droplet precautions
• D. Protective environment

Correct answer: B

Rationale: Tuberculosis is spread through small droplets, measuring less than 5 microns, which can remain airborne for extended periods. The nurse should place a client with TB under airborne precautions to prevent the transmission of the disease. Choice A, contact precautions, are used for diseases that spread by direct or indirect contact. Choice C, droplet precautions, are for diseases transmitted by large droplets. Choice D, protective environment, is used for clients who have compromised immune systems.

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