Nursing Elites

1. The healthcare provider has reinforced dietary instructions to a client with coronary artery disease. Which statement by the client indicates an understanding of the dietary instructions?

• A. I should substitute eggs and milk for meat.
• B. I will eliminate all cholesterol and fat from my diet.
• C. I should routinely use polyunsaturated oils in my diet.
• D. I need to consider becoming a strict vegetarian.

Correct answer: C

Rationale: The correct answer is C. Using polyunsaturated oils, such as vegetable oils, can help manage cholesterol levels and reduce the risk of heart disease. This dietary change is beneficial for individuals with coronary artery disease as it promotes heart health by improving cholesterol profiles. Substituting eggs and milk for meat (Choice A) may not address the overall dietary needs for managing the condition. Completely eliminating all cholesterol and fat from the diet (Choice B) is not necessary as the body needs some healthy fats. Considering becoming a strict vegetarian (Choice D) is a personal choice and may not necessarily be required to manage coronary artery disease.

2. A healthcare professional is preparing to administer ceftriaxone 1 g IM to a client who has a pelvic infection. Which of the following actions should the healthcare professional plan to take?

• A. Administer the medication via IM bolus over 5 minutes.
• B. Reconstitute with 0.9% sodium chloride.
• C. Discard the reconstituted medication if it is cloudy.
• D. Administer the medication in a large muscle.

Correct answer: D

Rationale: Administering ceftriaxone in a large muscle is crucial for proper absorption and to reduce the risk of pain or tissue irritation. Intramuscular administration of ceftriaxone helps achieve optimal therapeutic levels in the bloodstream for the treatment of the pelvic infection. Choices A, B, and C are incorrect. Choice A is not recommended as ceftriaxone should not be administered as a bolus over 5 minutes. Choice B is irrelevant because the question is about the administration route, not the reconstitution process. Choice C is also irrelevant as it does not pertain to the administration but to the quality of the reconstituted medication.

3. A client has a new prescription for prednisone. Which of the following statements should the nurse include in teaching the client?

• A. You may experience weight gain.
• B. Increase your intake of vitamin K.
• C. Expect increased urinary output.
• D. You may have dark, tarry stools.

Correct answer: A

Rationale: The correct answer is A. Weight gain is a common side effect of prednisone. The nurse should educate the client about the possibility of weight gain and the need to monitor it closely during treatment with prednisone. Choice B is incorrect because increasing vitamin K intake is not specifically related to prednisone therapy. Choice C is incorrect as prednisone is more likely to cause fluid retention rather than increased urinary output. Choice D is incorrect as dark, tarry stools are not a common side effect of prednisone.

4. When assessing a client receiving total parenteral nutrition (TPN), which laboratory value is most important for the nurse to monitor regularly?

• A. Albumin
• B. Calcium
• C. Glucose
• D. Alkaline phosphatase

Correct answer: C

Rationale: The most important laboratory value to monitor regularly in clients receiving total parenteral nutrition (TPN) is glucose. TPN solutions contain high concentrations of glucose, which can lead to hyperglycemia. Monitoring glucose levels is crucial to detect and prevent hyperglycemia, a common complication associated with TPN administration. Albumin (Choice A) levels are not typically affected by TPN administration. Calcium (Choice B) and alkaline phosphatase (Choice D) are not directly impacted by TPN and are not the primary values to monitor in TPN therapy.

5. The nurse is planning measures to decrease the incidence of chest pain for a client with angina pectoris. What intervention should the nurse do to effectively accomplish this goal?

• A. Provide a quiet and low-stimulus environment.
• B. Encourage the family to visit very frequently.
• C. Encourage the client to call friends and relatives each day.
• D. Recommend that the client watch TV as a constant diversion.

Correct answer: A

Rationale: The correct answer is A: Provide a quiet and low-stimulus environment. A calm and quiet environment can help reduce stress, which is beneficial in preventing the occurrence of chest pain in clients with angina. Choice B is incorrect because excessive or frequent visitations may lead to increased stress and agitation for the client. Choice C is incorrect as it may not always contribute to a calm environment and could potentially increase the client's stress levels. Choice D is inappropriate as watching TV constantly may not promote a quiet and low-stimulus environment, which is essential in managing angina pectoris.

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