Nursing Elites

1. A nurse is teaching a client who has a new prescription for alendronate. Which of the following client statements indicates an understanding of the teaching?

• A. I should take this medication at bedtime to prevent drowsiness.
• B. I should take this medication with a full glass of water before breakfast.
• C. I should avoid taking this medication with dairy products.
• D. I should remain upright for at least 30 minutes after taking this medication.

Correct answer: B

Rationale: The correct answer is B. Alendronate should be taken with a full glass of water before breakfast to prevent esophageal irritation and improve absorption. Choice A is incorrect as alendronate is not associated with causing drowsiness. Choice C is incorrect because alendronate can be taken with or without food, so avoiding dairy products is not necessary. Choice D is incorrect as the recommended time to remain upright after taking alendronate is 30 minutes to 1 hour, not just 30 minutes.

2. A nurse is teaching a client who has heart failure about managing fluid intake. Which of the following instructions should the nurse include?

• A. Drink 2 liters of water per day.
• B. You should restrict your fluid intake to 1 liter per day.
• C. You can drink as much fluid as you want throughout the day.
• D. Limit your fluid intake to 3 liters per day.

Correct answer: B

Rationale: The correct answer is B: "You should restrict your fluid intake to 1 liter per day." Clients with heart failure should limit their fluid intake to prevent fluid overload, which can worsen their condition. Choice A is incorrect because 2 liters of water per day may be excessive for someone with heart failure. Choice C is incorrect as unlimited fluid intake is not suitable for individuals with heart failure. Choice D is also incorrect as 3 liters per day may be too much fluid for a client with heart failure.

3. What is the recommended dietary restriction for a patient with chronic kidney disease?

• A. Limit potassium intake
• B. Limit fluid intake
• C. Increase protein intake
• D. Increase carbohydrate intake

Correct answer: B

Rationale: The correct answer is to limit fluid intake for a patient with chronic kidney disease. This restriction helps manage fluid balance to prevent fluid overload. Choices A, C, and D are incorrect. Limiting potassium intake is essential for some patients with kidney disease, but it is not the primary dietary restriction. Increasing protein intake is usually not recommended due to the impaired kidney function in these patients. Increasing carbohydrate intake is also not a standard recommendation for patients with chronic kidney disease.

4. A nurse is preparing an in-service for a group of nurses about malpractice issues in nursing. Which of the following examples should the nurse include in the teaching?

• A. Leaving a nasogastric tube clamped after administering oral medication.
• B. Documenting communication with a provider in the progress notes of the client's medical records.
• C. Administering potassium via IV bolus.
• D. Placing a yellow bracelet on a client who is at risk for falls.

Correct answer: C

Rationale: Administering potassium via IV bolus is a malpractice issue due to the risk of cardiac complications. Option A is incorrect as leaving a nasogastric tube clamped after administering oral medication can lead to complications but is not directly linked to malpractice. Option B is incorrect as documenting communication with a provider in the progress notes is a necessary part of nursing practice. Option D is incorrect as placing a yellow bracelet on a client at risk for falls is a safety measure to prevent falls and is not related to malpractice issues.

5. Nurses caring for four clients. Which of the following client data should the nurse report to the provider?

• A. A client who has pleurisy and reports pain of 6 on a scale of 0 to 10 when coughing
• B. Client drained a total of 110 mL of serosanguineous fluid from the Jackson Pratt drain within the first 24 hours following surgery
• C. Client who is 4 hours postoperative and has a heart rate of 98 per minute
• D. The client has a prescription for chemotherapy and an absolute neutrophil count of 75/mm3

Correct answer: D

Rationale: The correct answer is D. The client with chemotherapy and a low neutrophil count is at risk for infection and requires prompt intervention. Reporting this information to the provider is crucial to ensure appropriate monitoring and management to prevent potential complications. Choices A, B, and C do not indicate an immediate risk that requires immediate provider notification. A client reporting pain with pleurisy, a client draining fluid post-surgery, or a client with a heart rate of 98 per minute postoperative are not urgent enough to warrant immediate reporting compared to the client at risk for infection.

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