Nursing Elites

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

• A. I should take this medication with a full glass of water before breakfast.
• B. I should take this medication with food to prevent gastrointestinal upset.
• C. I should remain upright for at least 30 minutes after taking this medication.
• D. I should avoid taking this medication with antacids.

Correct answer: C

Rationale: The correct answer is C: "I should remain upright for at least 30 minutes after taking this medication." This statement indicates understanding because clients taking alendronate should remain upright for at least 30 minutes after taking the medication to prevent esophageal irritation. Choice A is incorrect because alendronate should be taken with a full glass of water after waking up, not before breakfast. Choice B is incorrect because alendronate should be taken on an empty stomach, not with food. Choice D is incorrect because alendronate should be taken separately from antacids.

2. A client who is at 10 weeks of gestation and experiencing nausea and vomiting is receiving teaching from a nurse. Which of the following statements should the nurse include?

• A. You should eat crackers before getting out of bed.
• B. You should drink ginger ale with your meals.
• C. You should lie down for 30 minutes after eating.
• D. You should avoid eating between meals.

Correct answer: A

Rationale: The correct answer is A: 'You should eat crackers before getting out of bed.' Eating crackers before getting out of bed can help reduce nausea and vomiting during pregnancy. This recommendation helps in stabilizing blood sugar levels before fully waking up. Choice B is incorrect because ginger ale may exacerbate nausea due to its carbonation. Choice C is incorrect as lying down after eating can worsen symptoms of nausea. Choice D is incorrect as avoiding eating between meals can lead to low blood sugar levels, worsening nausea and vomiting.

3. A nurse is preparing to teach a client about the use of a peak flow meter. Which of the following instructions should the nurse include?

• A. Place the mouthpiece in your mouth and blow out as quickly as you can.
• B. Exhale slowly into the mouthpiece over 5 seconds.
• C. Take a slow deep breath before blowing into the mouthpiece.
• D. Blow into the mouthpiece at a steady rate for 3 seconds.

Correct answer: A

Rationale: The correct instruction for using a peak flow meter is to place the mouthpiece in your mouth and blow out as quickly as you can. This action helps measure the peak expiratory flow of the client. Choice B is incorrect because exhaling slowly does not provide an accurate peak flow reading. Choice C is incorrect as taking a slow deep breath before blowing interferes with obtaining an accurate measurement. Choice D is incorrect as blowing at a steady rate for 3 seconds may not reflect the peak expiratory flow accurately.

4. Which of the following is a sign of digoxin toxicity?

• A. Bradycardia
• B. Hypertension
• C. Tachycardia
• D. Tachypnea

Correct answer: A

Rationale: The correct answer is A, Bradycardia. Bradycardia, or a slower than normal heart rate, is a classic sign of digoxin toxicity. Digoxin is a medication commonly used to treat heart conditions, but an excess of digoxin in the body can lead to toxicity. This toxicity can manifest as various symptoms, with bradycardia being one of the most common ones. Hypertension (high blood pressure) and tachycardia (fast heart rate) are not typical signs of digoxin toxicity. Tachypnea, which refers to rapid breathing, is also not a common sign of digoxin toxicity.

5. A nurse in a mental health facility receives a change of shift report on four clients. Which of the following clients should the nurse plan to assess first?

• A. Client placed in restraints due to aggressive behavior
• B. A new client with a history of 4.5 kg weight loss in the past two months
• C. Client receiving PRN dose of haloperidol 2 hours ago for anxiety
• D. Client receiving first ECT treatment today

Correct answer: A

Rationale: The nurse should plan to assess the client placed in restraints due to aggressive behavior first. Clients in restraints require immediate attention and frequent monitoring for safety. While weight loss, medication administration, and ECT treatment are important, the client in restraints is in a critical situation that requires immediate assessment and intervention.

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