Nursing Elites

1. A healthcare professional is providing discharge teaching to a client who has a new prescription for warfarin. Which of the following instructions should the healthcare professional include?

• A. Avoid drinking grapefruit juice.
• B. Take aspirin for pain relief.
• C. Consume a consistent amount of green leafy vegetables.
• D. Use an electric razor when shaving.

Correct answer: C

Rationale: Consuming a consistent amount of green leafy vegetables is important for clients taking warfarin as these foods contain vitamin K, which can affect the medication's effectiveness. Maintaining a consistent intake helps stabilize the International Normalized Ratio (INR) levels, which is crucial for monitoring the blood's ability to clot properly while on warfarin therapy. Choices A, B, and D are incorrect. Avoiding grapefruit juice is generally recommended with certain medications due to its interaction with liver enzymes, which is not directly related to warfarin. Taking aspirin along with warfarin can increase the risk of bleeding. Using an electric razor when shaving is a safety precaution for those at risk of bleeding, but it is not directly related to the medication warfarin.

2. A client is being assessed for dehydration. Which of the following findings should the nurse expect?

• A. Elevated blood pressure
• B. Increased skin turgor
• C. Dark-colored urine
• D. Bradypnea

Correct answer: C

Rationale: Dark-colored urine is a common sign of dehydration as the urine becomes concentrated. Dehydration leads to reduced fluid intake or excessive fluid loss, causing the urine to be darker in color due to increased urine concentration. Elevated blood pressure (Choice A) is not typically associated with dehydration; instead, dehydration often leads to low blood pressure. Increased skin turgor (Choice B) is actually a sign of good hydration, not dehydration. Bradypnea (Choice D), which refers to abnormally slow breathing, is not a common finding in dehydration.

3. A client reports difficulty sleeping at night, which interferes with daily functioning. Which intervention should the nurse suggest to this client?

• A. Avoid beverages containing caffeine
• B. Take a sleep medication regularly at bedtime
• C. Watch television for 30 minutes in bed to relax before falling asleep
• D. Advise the client to take several naps during the day

Correct answer: A

Rationale: The correct answer is A: Avoid beverages containing caffeine. Caffeine is a stimulant that can interfere with sleep, making it difficult for the client to fall asleep at night. Taking sleep medication regularly (choice B) may not address the root cause of the sleep difficulty and can lead to dependency. Watching television in bed (choice C) can actually stimulate the brain and hinder relaxation before sleep. Advising the client to take several naps during the day (choice D) can disrupt the sleep-wake cycle further. Therefore, recommending the avoidance of caffeine-containing beverages is the most appropriate intervention to help the client improve their ability to sleep at night and function better during the day.

4. During discharge instructions, a client with a new prescription for a metered-dose inhaler (MDI) states, 'I will shake the inhaler before each use.' Which of the following client statements indicates an understanding of the teaching?

• A. I will shake the inhaler before each use.
• B. I will use the inhaler immediately after meals.
• C. I will inhale the medication quickly.
• D. I will clean the mouthpiece with alcohol.

Correct answer: A

Rationale: The correct answer is A because shaking the inhaler before each use ensures that the medication is properly mixed, which is essential for effective administration. This action helps to disperse the medication evenly, enhancing its efficacy when inhaled. Proper mixing through shaking prevents inconsistent dosing and ensures that the client receives the correct amount of medication with each use.

5. A client with a new diagnosis of celiac disease is being taught about dietary management. Which of the following statements should be included by the healthcare provider?

• A. You should avoid foods that contain gluten.
• B. You should increase your intake of dairy products.
• C. You should avoid foods that contain lactose.
• D. You should increase your intake of high-fiber foods.

Correct answer: A

Rationale: The correct answer is A: 'You should avoid foods that contain gluten.' Gluten is a protein found in wheat, barley, and rye, which can trigger an immune response in individuals with celiac disease. Avoiding gluten-containing foods is crucial to managing the condition and preventing symptoms and complications associated with celiac disease. Choices B, C, and D are incorrect. Increasing dairy intake (Choice B) is not necessary for celiac disease management. Avoiding lactose (Choice C) is relevant for individuals with lactose intolerance, not celiac disease. While high-fiber foods (Choice D) are generally beneficial for health, they are not specifically indicated for celiac disease management.

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