Nursing Elites

1. A nurse is reviewing the medication orders for a client with heart failure. Which of the following medications should the nurse clarify with the provider?

• A. Furosemide
• B. Spironolactone
• C. Digoxin
• D. Ibuprofen

Correct answer: D

Rationale: The correct answer is D, Ibuprofen. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can worsen heart failure due to its effects on renal function and fluid retention. Therefore, the nurse should clarify the use of Ibuprofen with the provider. Choices A, B, and C (Furosemide, Spironolactone, and Digoxin) are commonly prescribed medications for heart failure that help manage symptoms and improve cardiac function, so they do not need clarification in this scenario.

2. A client is undergoing chemotherapy and expresses concern about hair loss. What is the best response?

• A. Reassure the client that hair loss is not permanent.
• B. Provide resources for wigs or hairpieces.
• C. Encourage the client to cut their hair short in advance.
• D. Advise the client that chemotherapy causes temporary hair loss.

Correct answer: D

Rationale: The best response when a client undergoing chemotherapy expresses concern about hair loss is to advise them that chemotherapy causes temporary hair loss. This response provides accurate information to the client about the side effect they are experiencing. Choice A is incorrect because it may provide false reassurance as for some individuals, hair loss can be a challenging experience. Choice B is not the best initial response as addressing the client's concerns and providing information should come first. Choice C is not the most appropriate response as cutting hair short may not necessarily prevent hair loss and does not address the client's concerns about the temporary nature of chemotherapy-induced hair loss.

3. The healthcare provider is assessing an immobile patient for deep vein thrombosis (DVT). What should the healthcare provider do?

• A. Lightly rub the lower leg to check for redness and tenderness.
• B. Apply elastic stockings every 4 hours.
• C. Measure the calf circumference of both legs.
• D. Flex the foot while assessing for patient discomfort.

Correct answer: C

Rationale: Measuring the calf circumference of both legs is crucial when assessing for DVT in an immobile patient. A significant increase in the circumference of one calf compared to the other suggests the presence of a deep vein thrombosis. Option A is incorrect because rubbing the lower leg may dislodge a clot if present. Option B is incorrect as elastic stockings should not be removed frequently as this can increase the risk of clot formation. Option D is incorrect as dorsiflexing the foot can lead to pain and should not be done to assess for DVT.

4. A client has a new prescription for folic acid and believes it's only for pregnant women. What statement should the nurse make?

• A. Folic acid is important only for pregnant women.
• B. You don’t need folic acid if you eat a balanced diet.
• C. Folic acid is important for the building of blood cells for adults and children.
• D. You should take folic acid only if your blood tests show a deficiency.

Correct answer: C

Rationale: The correct answer is C because folic acid is essential for the production of red blood cells in adults and children, not just for pregnant women. Option A is incorrect as folic acid is not exclusive to pregnant women. Option B is incorrect as a balanced diet may not provide sufficient folic acid. Option D is incorrect since folic acid supplementation is also recommended for other reasons beyond deficiency.

5. Which intervention is most effective in managing a patient with chronic pain?

• A. Administer opioid medications as prescribed.
• B. Teach the patient relaxation techniques.
• C. Encourage the patient to perform range of motion exercises.
• D. Recommend complete bed rest to minimize pain.

Correct answer: B

Rationale: The most effective intervention in managing a patient with chronic pain is teaching the patient relaxation techniques. Relaxation techniques can help reduce stress, decrease muscle tension, and improve pain management in patients with chronic pain. Administering opioids as prescribed may have risks of dependence and side effects, making it less favorable as a first-line intervention. Encouraging range of motion exercises can be beneficial, but relaxation techniques directly target stress reduction, a common exacerbating factor in chronic pain. Recommending complete bed rest is generally discouraged in chronic pain management as it can lead to deconditioning and worsen pain over time.

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