Nursing Elites

1. During a follow-up visit, a client with hypertension reports that they often forget to take their medication. What should the nurse do first?

• A. educate the client on the importance of medication adherence
• B. explore the reasons for the client's forgetfulness
• C. provide the client with a pill organizer
• D. adjust the client's medication schedule

Correct answer: B

Rationale: The correct first action for the nurse is to explore the reasons for the client's forgetfulness. By understanding the underlying causes, the nurse can provide tailored interventions to help the client improve medication adherence. Providing education on the importance of adherence (Choice A) may be necessary but should come after identifying the reasons for forgetfulness. Simply providing a pill organizer (Choice C) or adjusting the medication schedule (Choice D) does not address the root cause of the forgetfulness and may not lead to sustained improvement in adherence.

2. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen therapy. Which finding indicates that the therapy is effective?

• A. The client is able to expectorate secretions easily.
• B. The client's oxygen saturation is 92%.
• C. The client's respiratory rate is 20 breaths per minute.
• D. The client's arterial blood gases show a pH of 7.35.

Correct answer: C

Rationale: In a client with COPD receiving oxygen therapy, an effective response is indicated by a respiratory rate of 20 breaths per minute. This suggests that the client is effectively oxygenating while maintaining an appropriate respiratory rate. Choices A, B, and D are incorrect because expectorating secretions easily, having an oxygen saturation of 92%, and arterial blood gases showing a pH of 7.35 are not specific indicators of the effectiveness of oxygen therapy in COPD. Oxygen saturation of 92% may still be suboptimal in COPD, and arterial blood gases showing a pH of 7.35 may not necessarily reflect the overall effectiveness of oxygen therapy.

3. A nurse is planning a community health fair to promote cancer awareness. Which activity should be included to best engage participants?

• A. free cancer screenings
• B. lectures on cancer prevention
• C. distribution of educational materials
• D. testimonials from cancer survivors

Correct answer: A

Rationale: Offering free cancer screenings should be included in the community health fair to best engage participants. This activity provides immediate, valuable information about participants' cancer risk, making it highly engaging and actionable. While lectures on cancer prevention and distribution of educational materials are informative, they may not offer the same level of immediate engagement and impact as free screenings. Testimonials from cancer survivors, although inspiring, do not provide participants with direct information about their own cancer risk, making them less effective in engaging participants actively.

4. The nurse is providing care for a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which laboratory result requires immediate intervention?

• A. Serum sodium of 140 mEq/L.
• B. Serum potassium of 4.5 mEq/L.
• C. Serum osmolality of 280 mOsm/kg.
• D. Serum sodium of 130 mEq/L.

Correct answer: D

Rationale: The correct answer is D: Serum sodium of 130 mEq/L. In SIADH, there is excess release of antidiuretic hormone leading to water retention and dilutional hyponatremia. A serum sodium level of 130 mEq/L indicates severe hyponatremia, which can result in neurological symptoms, such as confusion, seizures, and coma. Therefore, immediate intervention is required to prevent further complications. Choice A, a serum sodium of 140 mEq/L, is within the normal range and does not require immediate intervention. Choice B, serum potassium of 4.5 mEq/L, is also within the normal range and is not directly related to SIADH. Choice C, serum osmolality of 280 mOsm/kg, is a measure of the concentration of solutes in the blood and may not be the most critical parameter to address in a client with SIADH and severe hyponatremia.

5. The healthcare professional is developing a program to educate parents on childhood safety. Which topic should be prioritized?

• A. the benefits of car seats
• B. how to childproof the home
• C. the importance of helmet use
• D. ways to prevent drowning

Correct answer: B

Rationale: Prioritizing the topic of how to childproof the home is crucial as it provides a holistic approach to safeguarding children from various injuries within the home environment. Childproofing the home addresses a wide range of hazards such as falls, burns, poisoning, and choking incidents. While topics like the benefits of car seats, the importance of helmet use, and ways to prevent drowning are important, childproofing the home covers a broader spectrum of safety measures that can significantly reduce the risk of injuries for children.

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