Nursing Elites

1. A client at risk for coronary artery disease seeks advice from a nurse. What should the nurse recommend to reduce the risk?

• A. Increase your intake of saturated fats.
• B. Exercise for 150 minutes per week.
• C. Take iron supplements daily.
• D. Limit fruits and vegetables in your diet.

Correct answer: B

Rationale: The correct recommendation to reduce the risk of coronary artery disease is to exercise for at least 150 minutes per week. Regular exercise is crucial in maintaining cardiovascular health and reducing the chances of developing heart disease. Increasing intake of saturated fats (Choice A) is counterproductive as it can raise cholesterol levels and contribute to arterial plaque formation. Taking iron supplements daily (Choice C) is not directly related to reducing the risk of coronary artery disease. Limiting fruits and vegetables in the diet (Choice D) is also not advisable, as they are essential components of a heart-healthy diet due to their high fiber and nutrient content.

2. A client has a stool culture positive for C. difficile. What action should the nurse take?

• A. Place the client in a negative pressure room
• B. Use alcohol-based hand rub after providing care
• C. Wear a face shield before entering the room
• D. Place the client in a private room

Correct answer: D

Rationale: When caring for a client with a C. difficile infection, it is essential to isolate them in a private room to prevent the spread of spores through contact with surfaces. Placing the client in a negative pressure room (Choice A) is not necessary for C. difficile. Using alcohol-based hand rub (Choice B) and wearing a face shield (Choice C) are important infection control measures but are not specific to the isolation requirements for C. difficile.

3. A client with cholecystitis has been prescribed a low-fat diet. Which of the following meal selections by the client indicates understanding of the education?

• A. Roast beef with gravy, mashed potatoes, ice cream
• B. Macaroni and cheese, salad, pudding
• C. Creamed chicken on a roll with peas
• D. Roast turkey, rice pilaf, green beans

Correct answer: D

Rationale: The correct answer is D. Roast turkey is a lean protein option suitable for a low-fat diet. Rice pilaf and green beans are also low in fat. Choices A, B, and C contain high-fat ingredients like gravy, cheese, cream, and ice cream, which are not suitable for a low-fat diet.

4. A healthcare provider is assessing a client who is receiving heparin therapy for deep vein thrombosis (DVT). Which of the following laboratory values should the provider monitor to evaluate the therapeutic effect of the heparin?

• A. Platelet count
• B. Partial thromboplastin time (PTT)
• C. Prothrombin time (PT)
• D. Bleeding time

Correct answer: B

Rationale: The Partial Thromboplastin Time (PTT) is the correct laboratory value to monitor heparin therapy. PTT measures the time it takes for blood to clot and is specifically used to evaluate the effectiveness of anticoagulation therapy such as heparin. Monitoring the PTT helps ensure that the heparin dose is within the therapeutic range. Platelet count, Prothrombin time (PT), and Bleeding time are not specific laboratory values for monitoring the therapeutic effect of heparin therapy. Platelet count is more indicative of platelet function, PT is used to monitor warfarin therapy, and Bleeding time assesses platelet function rather than the effect of heparin therapy.

5. A client who is 32 weeks pregnant and has a diagnosis of placenta previa is receiving teaching from a nurse. Which of the following instructions should the nurse include?

• A. Limit physical activity
• B. Monitor fetal movements daily
• C. Call the healthcare provider if contractions begin
• D. All of the above

Correct answer: D

Rationale: Clients diagnosed with placenta previa are at an increased risk of bleeding and preterm labor. Therefore, it is essential for them to limit physical activity to prevent complications. Monitoring fetal movements daily helps in assessing the well-being of the fetus. Additionally, notifying the healthcare provider if contractions begin is crucial as it could be a sign of preterm labor. Therefore, all of the instructions (limiting physical activity, monitoring fetal movements, and calling the healthcare provider if contractions begin) are necessary for managing placenta previa effectively. Choices A, B, and C are all correct instructions for a client with placenta previa.

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