Nursing Elites

1. A nurse is providing discharge instructions to a client following a below-the-knee amputation. Which of the following instructions should the nurse include?

• A. Avoid sitting in a chair for prolonged periods.
• B. Sleep with a pillow under the residual limb.
• C. Elevate the limb continuously for the first 48 hours.
• D. Apply lotion to the residual limb daily.

Correct answer: A

Rationale: The correct answer is to instruct the client to avoid sitting in a chair for prolonged periods. This is important to prevent contractures from developing in the residual limb. Sleeping with a pillow under the residual limb can contribute to contracture formation rather than prevent it. While elevation of the limb is important for reducing swelling and promoting circulation, continuous elevation for 48 hours is not necessary and may not be practical. Applying lotion to the residual limb daily is generally not recommended immediately post-amputation as the wound site needs to heal without interference from lotions or creams.

2. A nurse is teaching a client about the use of alendronate. Which of the following should be included in the teaching?

• A. Take it with food
• B. Sit upright for at least 30 minutes after taking it
• C. It can be taken at bedtime
• D. It is safe to take with antacids

Correct answer: B

Rationale: The correct answer is B: 'Sit upright for at least 30 minutes after taking it.' Alendronate can cause esophageal irritation and to reduce the risk of this side effect, clients should be instructed to sit upright for at least 30 minutes after administration. Choice A is incorrect as alendronate should be taken on an empty stomach, usually in the morning, at least 30 minutes before the first food, beverage, or medication of the day. Choice C is incorrect because alendronate should not be taken at bedtime, as the client should remain upright for at least 30 minutes after taking it. Choice D is incorrect as antacids can interfere with the absorption of alendronate, so they should not be taken together.

3. A nurse is discussing immunity with a client who has received an immunization. The nurse should identify that an immunization functions as part of which of the following types of immunity?

• A. Innate immunity
• B. Passive immunity
• C. Acquired immunity
• D. Natural immunity

Correct answer: C

Rationale: Immunizations provide acquired immunity. They work by introducing antigens into the body, which triggers the immune system to produce antibodies specific to that antigen. Choice A, 'Innate immunity,' refers to the natural defense mechanisms an organism is born with and does not involve immunizations. Choice B, 'Passive immunity,' is the transfer of pre-formed antibodies and does not involve immunizations. Choice D, 'Natural immunity,' is a general term that encompasses all immunity that is not acquired through deliberate immunization or passive transfer of antibodies.

4. A nurse is teaching a client about using a continuous positive airway pressure (CPAP) device to treat obstructive sleep apnea. Which of the following information should the nurse include in the teaching?

• A. It delivers a preset amount of inspiratory pressure at the beginning of each breath
• B. It has a continuous adjustment feature that changes the airway pressure throughout the cycle
• C. It delivers a preset amount of airway pressure throughout the breathing cycle
• D. It delivers positive pressure at the end of each breath

Correct answer: C

Rationale: The correct information that the nurse should include in the teaching about a CPAP device is that it delivers a preset amount of airway pressure throughout the breathing cycle. This consistent positive airway pressure helps keep the airway open during both inspiration and expiration. Choice A is incorrect as CPAP does not deliver pressure only at the beginning of each breath. Choice B is incorrect because CPAP provides a constant level of pressure without continuous adjustments throughout the cycle. Choice D is incorrect as CPAP does not provide positive pressure at the end of each breath; instead, it maintains a continuous positive pressure.

5. A nurse is teaching a client about the use of fluoxetine. Which of the following should be included?

• A. It can take several weeks for effects to be noticed
• B. It is an antipsychotic medication
• C. It should be taken at night
• D. It has no side effects

Correct answer: A

Rationale: Corrected Rationale: When educating a client about fluoxetine, it is essential to mention that it can take several weeks for the therapeutic effects to be noticed. This is because fluoxetine is an SSRI that requires time to build up in the body and start producing its intended effects. Choice B is incorrect as fluoxetine is not an antipsychotic medication but an SSRI. Choice C is inaccurate because fluoxetine can be taken at any time of the day, and there is no specific requirement to take it at night. Choice D is incorrect as all medications, including fluoxetine, have potential side effects that should be discussed with the client.

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