Nursing Elites

1. After a sudden loss of consciousness, a female client is taken to the ED, and initial assessment indicates that her blood glucose level is critically low. Once her glucose level is stabilized, the client reports that she was recently diagnosed with anorexia nervosa and is being treated at an outpatient clinic. Which intervention is more important to include in this client’s discharge plan?

• A. Describe the importance of maintaining stable blood glucose levels.
• B. Encourage a balanced and nutritious diet.
• C. Reinforce the need to continue outpatient treatment.
• D. Educate on the risks of untreated anorexia nervosa.

Correct answer: C

Rationale: Continuing outpatient treatment is crucial for managing anorexia nervosa and preventing future complications. Reinforcing the need to continue outpatient treatment ensures ongoing support, monitoring, and therapy for the client's anorexia nervosa. Describing the importance of maintaining stable blood glucose levels (Choice A) is relevant but does not address the underlying eating disorder directly. Encouraging a balanced and nutritious diet (Choice B) is important; however, specific dietary recommendations should be tailored to the individual's condition by healthcare providers. Educating on the risks of untreated anorexia nervosa (Choice D) is informative but does not provide a direct actionable step for the client's immediate discharge plan, unlike the importance of continuing outpatient treatment.

2. What action should the nurse implement for a female client with cancer who has a good appetite but experiences nausea whenever she smells food cooking?

• A. Encourage family members to cook meals outdoors and bring the cooked food inside
• B. Advise the client to replace cooked foods with a variety of different nutritional supplements
• C. Assess the client’s mucus membranes and report the findings to the healthcare provider
• D. Instruct the client to take an antiemetic before every meal to prevent excessive vomiting

Correct answer: A

Rationale: The correct action for the nurse to implement is to encourage family members to cook meals outdoors and bring the cooked food inside. This strategy can help reduce the smell of cooking food and potentially alleviate the client's nausea triggered by food smells. Assessing the client's mucus membranes (choice C) is not directly related to the client's symptom of nausea triggered by food smells. Instructing the client to take an antiemetic before every meal (choice D) may not address the root cause of the issue, which is the smell of cooking food. Advising the client to replace cooked foods with nutritional supplements (choice B) does not address the immediate problem of food odors triggering nausea.

3. The charge nurse is making assignments for clients on an endocrine unit. Which client is best to assign to a new graduate nurse?

• A. A female adult with hyperthyroidism who is returning to the unit after a thyroidectomy
• B. A male adult with Cushing's syndrome who reports a headache and visual disturbances
• C. An older man with Addison's disease who is diaphoretic and has hand tremors
• D. A perimenopausal woman with Graves' disease who is nervous and has exophthalmos

Correct answer: A

Rationale: A new graduate nurse can manage the care of a stable client returning from a thyroidectomy. Choice B is not suitable for a new graduate nurse as it involves complex symptoms of Cushing's syndrome that require more experience and knowledge. Choice C presents a client with acute manifestations of Addison's disease, which may be challenging for a new graduate nurse. Choice D involves a client with Graves' disease experiencing nervousness and exophthalmos, which also require a higher level of expertise to manage effectively.

4. For a client with pneumonia, the prescription states, “Oxygen at liters/min per nasal cannula PRN difficult breathing.” Which nursing intervention is effective in preventing oxygen toxicity?

• A. Avoiding the administration of oxygen at high levels for extended periods.
• B. Administering a sedative at bedtime to slow the client’s respiratory rate.
• C. Removing the nasal cannula during the night to prevent oxygen buildup.
• D. Running oxygen through a hydration source prior to administration.

Correct answer: A

Rationale: Choice A is the correct answer because prolonged exposure to high levels of oxygen can lead to oxygen toxicity. Administering oxygen at high levels for extended periods can overwhelm the body's natural defenses against high oxygen levels, causing toxicity. Choices B, C, and D are incorrect. Choice B is unrelated to preventing oxygen toxicity. Choice C is unsafe as removing the nasal cannula can deprive the client of necessary oxygen. Choice D, running oxygen through a hydration source, is not a standard practice for preventing oxygen toxicity.

5. A young adult male who is being seen at the employee health care clinic for an annual assessment tells the nurse that his mother was diagnosed with schizophrenia when she was his age and that life with a schizophrenic mother was difficult indeed. Which response is best for the nurse to provide?

• A. Ask the client if he is worried about becoming schizophrenic at the age his mother was diagnosed.
• B. Encourage the client to seek genetic counseling to determine his risk for mental illness.
• C. Inform the client that his mother’s schizophrenia has affected his psychological development.
• D. Tell the client that mental illness has a familial predisposition so he should see a psychiatrist.

Correct answer: B

Rationale: Genetic counseling can help assess risk and provide guidance for the client’s concerns about potential hereditary conditions.

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