Nursing Elites

1. The home care nurse visits a client who has cancer. The client reports having a good appetite but experiencing nausea when smelling food cooking. Which action should the nurse implement?

• A. Encourage family members to cook meals outdoors and bring the cooked food inside
• B. Provide anti-nausea medication prior to meals
• C. Suggest drinking cold water with meals to reduce nausea
• D. Recommend smaller, frequent meals

Correct answer: A

Rationale: In some cases, the smell of food cooking can trigger nausea in cancer patients. Cooking food outside reduces the intensity of odors that could trigger nausea, helping the client maintain adequate nutrition. Providing anti-nausea medication (Choice B) may not address the root cause of the nausea triggered by the smell of cooking food. Suggesting cold water (Choice C) or smaller, frequent meals (Choice D) may not directly address the issue of cooking odors triggering nausea, which is specific to this client's situation.

2. A client recovering from a stroke is demonstrating slurred speech. What action should the nurse take?

• A. Consult the healthcare provider to order speech therapy.
• B. Administer a dose of aspirin to prevent further neurological damage.
• C. Encourage the client to use communication aids, such as writing.
• D. Encourage the client to eat soft foods to avoid choking.

Correct answer: C

Rationale: The correct action for a client recovering from a stroke demonstrating slurred speech is to encourage the client to use communication aids, such as writing. This intervention can help the client effectively communicate while working on regaining speech abilities. Consulting the healthcare provider to order speech therapy (choice A) is a valid option, but immediate encouragement of using communication aids is beneficial. Administering aspirin (choice B) without healthcare provider orders is not recommended. Encouraging the client to eat soft foods (choice D) is important for preventing aspiration but doesn't directly address the communication issue.

3. A client in labor is experiencing late decelerations in fetal heart rate. What intervention should the nurse perform first?

• A. Reposition the client onto her left side.
• B. Apply oxygen via nasal cannula.
• C. Prepare for an emergency cesarean section.
• D. Increase IV fluid administration to improve perfusion.

Correct answer: A

Rationale: Late decelerations indicate fetal distress due to compromised placental perfusion. Repositioning the client onto her left side is the priority intervention as it can increase blood flow to the placenta, improving fetal oxygenation. Applying oxygen via nasal cannula (choice B) can be the next step after repositioning if late decelerations persist. Emergency cesarean section (choice C) is not the initial action for late decelerations unless other interventions are ineffective. Increasing IV fluid administration (choice D) is not the first-line intervention for late decelerations; repositioning takes precedence to address the underlying cause.

4. A client with chronic obstructive pulmonary disease (COPD) is prescribed home oxygen therapy. What teaching should the nurse provide?

• A. Ensure that the client uses oxygen continuously at night.
• B. Instruct the client to avoid smoking and exposure to smoke.
• C. Teach the client how to clean and replace the oxygen tubing.
• D. Instruct the client to increase their fluid intake.

Correct answer: C

Rationale: The correct teaching for a client with COPD prescribed home oxygen therapy is to educate them on how to clean and replace the oxygen tubing. This is crucial to prevent infections and ensure the effectiveness of the oxygen delivery system. Option A is not necessary as oxygen therapy is usually prescribed as needed, not continuously at night. While smoking cessation and avoiding smoke exposure are important in COPD management, it is not directly related to home oxygen therapy. Increasing fluid intake is beneficial for some conditions but is not specifically related to home oxygen therapy for COPD.

5. A client with chronic kidney disease is receiving erythropoietin injections. What laboratory value should the nurse monitor to evaluate the effectiveness of the treatment?

• A. Serum potassium
• B. Hemoglobin
• C. White blood cell count
• D. Platelet count

Correct answer: B

Rationale: The correct answer is B: Hemoglobin. Erythropoietin stimulates the production of red blood cells, leading to an increase in hemoglobin levels. Monitoring hemoglobin is crucial to assess the effectiveness of the treatment. Choices A, C, and D are incorrect. Serum potassium levels are often monitored in chronic kidney disease, but it is not the primary parameter to evaluate the effectiveness of erythropoietin therapy. White blood cell count and platelet count are not directly influenced by erythropoietin injections for chronic kidney disease.

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