Nursing Elites

1. A nurse is reviewing the prescription for doxazosin with a client. Which of the following should be included in the teaching?

• A. Decrease caloric intake to prevent weight gain.
• B. Increase dietary fiber to alleviate constipation.
• C. Rise slowly when sitting up from bed.
• D. Take this medication in the morning.

Correct answer: C

Rationale: The correct answer is C. Doxazosin can cause orthostatic hypotension, leading to dizziness and falls if the client rises quickly from a seated position. Instructing the client to rise slowly when sitting up from bed helps prevent these adverse effects. Choices A, B, and D are incorrect because doxazosin does not directly relate to caloric intake, dietary fiber, or a specific time of day for administration.

2. A patient is being cared for by a nurse who has a history of angina and is experiencing chest pain. Which of the following actions should the nurse take first?

• A. Administer oxygen at 2 L/min via nasal cannula.
• B. Administer nitroglycerin sublingually.
• C. Obtain a 12-lead ECG.
• D. Notify the healthcare provider.

Correct answer: C

Rationale: In a patient with a history of angina experiencing chest pain, the priority action for the nurse is to obtain a 12-lead ECG. This helps in assessing for myocardial infarction, a serious condition that requires immediate attention. Administering oxygen, nitroglycerin, or notifying the healthcare provider can be important interventions but obtaining the ECG comes first to determine the presence of myocardial infarction and guide further management.

3. A client with gastroesophageal reflux disease (GERD) is being taught about lifestyle changes to manage the condition. Which of the following instructions should the nurse include?

• A. Avoid eating small, frequent meals.
• B. Sleep with the head of your bed elevated.
• C. Lie down after eating.
• D. Avoid drinking fluids with meals.

Correct answer: B

Rationale: The correct answer is B: 'Sleep with the head of your bed elevated.' Elevating the head of the bed helps reduce acid reflux by keeping the head higher than the stomach, preventing stomach acid from flowing back into the esophagus. Choices A, C, and D are incorrect. Avoiding eating small, frequent meals, lying down after eating, and drinking fluids with meals can exacerbate GERD symptoms by increasing stomach acid production and promoting acid reflux.

4. A nurse is caring for a client who is receiving radiation therapy for breast cancer. Which of the following skin care instructions should the nurse provide?

• A. Wear loose clothing over the radiation site.
• B. Use scented lotions to moisturize the skin.
• C. Apply ice packs to the radiation site for pain relief.
• D. Expose the radiation site to sunlight for 20 minutes daily.

Correct answer: A

Rationale: The correct answer is A: Wear loose clothing over the radiation site. Clients receiving radiation therapy should wear loose clothing over the treatment area to prevent irritation and promote healing. Choice B is incorrect as scented lotions can irritate the skin during radiation therapy. Choice C is incorrect because ice packs should not be applied to the radiation site as they can exacerbate skin reactions. Choice D is incorrect as exposing the radiation site to sunlight can increase skin damage and should be avoided.

5. A client who has a new prescription for prednisone is being discharged. Which of the following client statements indicates an understanding of the teaching?

• A. I should take this medication with food.
• B. I will need to take this medication for the rest of my life.
• C. I should avoid crowded places while taking this medication.
• D. I will take this medication until my symptoms resolve.

Correct answer: C

Rationale: The correct answer is C. Clients taking prednisone should avoid crowded places to reduce the risk of infection due to immunosuppression. Choice A is incorrect because prednisone should be taken with food to reduce stomach upset. Choice B is incorrect as prednisone is usually prescribed for a specific duration and not for life. Choice D is incorrect because prednisone should be taken as prescribed by the healthcare provider, which may not always align with symptom resolution.

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