Nursing Elites

1. A client who has undergone vein ligation and stripping to treat varicose veins should be instructed to do which of the following activities during discharge teaching?

• A. Remain sedentary for 2-3 days
• B. Walk for 1-2 hours each day
• C. Wear compression stockings only at night
• D. Elevate legs while sitting

Correct answer: B

Rationale: The correct answer is B: 'Walk for 1-2 hours each day.' After vein ligation and stripping, walking helps promote circulation and aids in the recovery process. Option A is incorrect as remaining sedentary for 2-3 days can lead to decreased circulation and potentially increase the risk of complications. Option C is incorrect because compression stockings should typically be worn during the day to support circulation. Option D is incorrect as elevating the legs while sitting is beneficial, but walking is more effective in promoting circulation and recovery in this case.

2. What is the most important action when providing wound care to a client with a pressure ulcer?

• A. Apply a dry, sterile dressing to the wound
• B. Cleanse the wound with normal saline
• C. Perform a wound culture before applying ointment
• D. Cover the wound with a wet-to-dry dressing

Correct answer: C

Rationale: Performing a wound culture before applying ointment is crucial when providing wound care to a client with a pressure ulcer. This action helps identify any underlying infections, allowing healthcare providers to select the most appropriate treatment. Options A, B, and D are not as critical as performing a wound culture, as they focus on wound dressing and cleansing rather than identifying potential infections.

3. A nurse is preparing to administer metoclopramide 10 mg IM. Available is metoclopramide 5 mg/mL. How many mL should the nurse administer?

• A. 1 mL
• B. 2 mL
• C. 3 mL
• D. 4 mL

Correct answer: B

Rationale: To administer 10 mg of metoclopramide, the nurse should administer 2 mL (10 mg / 5 mg per mL). Therefore, the correct answer is 2 mL. Choice A (1 mL) is incorrect because it would only deliver 5 mg of metoclopramide, which is half the required dose. Choice C (3 mL) and D (4 mL) are incorrect as they would provide more than the required dose of 10 mg.

4. What intervention is key when managing a client with delirium?

• A. Administer antipsychotic medication to calm the client
• B. Identify any reversible causes of delirium
• C. Provide a low-stimulation environment
• D. Increase environmental stimulation

Correct answer: B

Rationale: The correct intervention when managing a client with delirium is to identify any reversible causes. Delirium can be caused by various factors such as infections, medications, dehydration, or metabolic imbalances. Administering antipsychotic medications (Choice A) may worsen delirium and should be avoided unless necessary for specific indications. Providing a low-stimulation environment (Choice C) is beneficial as it can help reduce agitation and confusion in individuals with delirium. Increasing environmental stimulation (Choice D) is contraindicated as it can exacerbate symptoms in delirious patients. Therefore, the priority should be on identifying and addressing reversible causes to effectively manage delirium.

5. How should a healthcare provider manage a patient with hypertensive crisis?

• A. Administer antihypertensive medications and monitor blood pressure
• B. Provide a high-sodium diet and fluid restriction
• C. Administer diuretics and provide oxygen therapy
• D. Provide IV fluids and monitor for kidney failure

Correct answer: A

Rationale: In a hypertensive crisis, the immediate goal is to lower blood pressure to prevent organ damage. Administering antihypertensive medications helps achieve this goal efficiently. Monitoring blood pressure is essential to assess the effectiveness of the treatment and adjust medication as needed. Providing a high-sodium diet and fluid restriction (Choice B) can exacerbate hypertension by increasing blood pressure. Diuretics and oxygen therapy (Choice C) are not the first-line treatment for hypertensive crisis, as the priority is rapid blood pressure reduction. Providing IV fluids and monitoring for kidney failure (Choice D) are not primary interventions for managing hypertensive crisis; the focus is on blood pressure control and organ protection.

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