Nursing Elites

1. When developing a plan of care for a client with dementia, what should the LPN/LVN remember about confusion in the elderly?

• A. It is not a normal part of aging.
• B. It often follows relocation to new surroundings.
• C. It is primarily due to changes in the brain associated with the disease.
• D. It cannot be prevented or cured by adequate sleep alone.

Correct answer: B

Rationale: When caring for a client with dementia, it is crucial to understand that confusion often arises after relocating to new surroundings. This change can disrupt familiar routines and trigger increased disorientation and confusion. Choice A is correct because confusion in the elderly is not a normal part of aging. Choice C is incorrect because confusion in dementia is primarily due to changes in the brain associated with the disease, not just irreversible brain pathology. Choice D is incorrect because while adequate sleep is important for overall health, it alone cannot prevent or cure confusion associated with dementia.

2. When should the client administer the inhaler-delivered medication to demonstrate correct use of the inhaler?

• A. Immediately after exhalation.
• B. During the inhalation.
• C. At the end of three inhalations.
• D. Immediately after inhalation.

Correct answer: B

Rationale: The correct answer is B: 'During the inhalation.' Administering the medication while inhaling ensures proper delivery to the lungs. Inhaling the medication allows it to reach the lungs effectively for optimal therapeutic benefit. Choices A, C, and D are incorrect because administering the medication after exhalation or at the end of inhalations may result in improper drug delivery and reduced therapeutic effects.

3. A client with a history of chronic obstructive pulmonary disease (COPD) is being discharged with home oxygen therapy. Which statement by the client indicates a need for further teaching?

• A. I will keep my oxygen tank upright at all times.
• B. I will not use petroleum jelly to keep my nose from drying out.
• C. I will not smoke or allow others to smoke around me.
• D. I will call my doctor if I have difficulty breathing.

Correct answer: B

Rationale: The correct answer is B. Petroleum jelly is flammable and should not be used with oxygen therapy as it can increase the risk of fire. Using petroleum jelly near oxygen can lead to a fire hazard. Choices A, C, and D are correct statements that indicate proper understanding of oxygen therapy safety measures. Choice A emphasizes the importance of keeping the oxygen tank upright to prevent leaks, choice C highlights the necessity of avoiding smoking to prevent exacerbation of COPD, and choice D encourages seeking medical help promptly in case of breathing difficulties.

4. An 80-year-old client admitted with a diagnosis of a possible cerebral vascular accident has had a blood pressure ranging from 180/110 to 160/100 over the past 2 hours. The nurse has also noted increased lethargy. Which assessment finding should the nurse report immediately to the healthcare provider?

• A. Slurred speech
• B. Incontinence
• C. Muscle weakness
• D. Rapid pulse

Correct answer: A

Rationale: Slurred speech is a classic sign of a worsening stroke, suggesting a potential blockage or hemorrhage affecting speech centers in the brain. Prompt reporting of this symptom to the healthcare provider is crucial for immediate evaluation and intervention. While incontinence (Choice B) is important to monitor, it is not considered an immediate priority over slurred speech in this context. Muscle weakness (Choice C) and rapid pulse (Choice D) are also relevant in stroke assessment, but slurred speech takes precedence due to its strong association with neurological deficits in the setting of a possible cerebral vascular accident.

5. A healthcare professional is planning to collect a liquid stool specimen from a client for ova and parasites. Inaccurate test results may result if the healthcare professional:

• A. Refrigerates the collected specimen
• B. Collects the specimen in a sterile container
• C. Delays the collection of the specimen
• D. Uses a non-contaminated collection container

Correct answer: A

Rationale: Refrigeration can kill the ova and parasites present in the stool specimen, leading to inaccurate test results. Storing the specimen in a cold environment can disrupt the integrity of the parasites and ova, affecting the accuracy of the test. Collecting the specimen in a sterile container (Choice B) is the correct procedure to prevent external contamination. Delaying the collection of the specimen (Choice C) may affect the freshness of the sample but does not directly impact the test results. Using a non-contaminated collection container (Choice D) is essential to maintain the sample's integrity but does not relate to the risk of killing ova and parasites through refrigeration.

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