Nursing Elites

1. A client with a new diagnosis of cirrhosis is receiving dietary management education from a nurse. Which of the following statements should the nurse include in the teaching?

• A. You should increase your intake of sodium-rich foods.
• B. You should decrease your intake of sodium-rich foods.
• C. You should avoid foods that contain lactose.
• D. You should increase your intake of dairy products.

Correct answer: B

Rationale: Reducing the intake of sodium-rich foods is beneficial for managing fluid retention and symptoms of cirrhosis. Excessive sodium can lead to fluid buildup in the body, worsening edema and ascites commonly associated with cirrhosis. Therefore, advising the client to decrease their intake of sodium-rich foods is crucial in the dietary management of cirrhosis. Option A is incorrect as increasing sodium intake would exacerbate fluid retention. Option C is irrelevant to cirrhosis management unless the client has lactose intolerance. Option D is incorrect as increasing dairy product intake may not be suitable for all patients with cirrhosis, especially if they have complications like hepatic encephalopathy.

2. A client with a new prescription for a dry-powder inhaler (DPI) is receiving teaching from a healthcare provider. Which of the following statements indicates an understanding of the teaching?

• A. I will shake the inhaler before use.
• B. I will take the medication with food.
• C. I will inhale the medication quickly.
• D. I will use a spacer with the inhaler.

Correct answer: C

Rationale: Choosing option C, 'I will inhale the medication quickly,' demonstrates an understanding of DPI use. Inhaling the medication quickly ensures effective delivery of the dry powder to the lungs, maximizing its therapeutic effects. Options A, B, and D are incorrect as shaking the DPI, taking it with food, and using a spacer are not recommended practices for DPI administration. Shaking a DPI can cause clumping or uneven dispersion of the medication, taking it with food may not affect its efficacy but can increase the risk of side effects, and using a spacer is not necessary for DPIs which are breath-actuated and do not require coordination with inhalation through a spacer.

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 postoperative teaching following a hip arthroplasty, which instruction should the nurse include?

• A. Avoid lying on your operative side.
• B. Cross your legs at the ankles only.
• C. Place a pillow between your legs when turning.
• D. Avoid bending your hip more than 120 degrees.

Correct answer: C

Rationale: The correct instruction for the nurse to include during postoperative teaching following a hip arthroplasty is to 'Place a pillow between your legs when turning.' Placing a pillow between the legs when turning is crucial as it helps prevent dislocation of the hip prosthesis. This position aids in maintaining proper alignment and stability, thereby reducing the risk of complications after hip arthroplasty surgery. Choices A, B, and D are incorrect because they do not directly address the specific action needed to protect the hip prosthesis and prevent complications.

5. When admitting a client at risk for falls in a long-term care facility, what should the nurse do first?

• A. Complete a fall-risk assessment
• B. Place a fall-risk identification bracelet on the client
• C. Provide the client with nonskid footwear
• D. Set the bed to the lowest position

Correct answer: A

Rationale: The initial step in caring for a client at risk for falls is to conduct a fall-risk assessment. This assessment helps the nurse gather crucial data to identify specific risks and individualized needs, guiding subsequent interventions and preventive measures. By completing a thorough assessment, the nurse can develop a targeted plan of care to mitigate fall risk and ensure the client's safety. Placing a fall-risk identification bracelet, providing nonskid footwear, or setting the bed to the lowest position may be important interventions, but these actions should be based on the findings of the fall-risk assessment, making choice A the priority.

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