Nursing Elites

1. The nurse has completed the admission assessment of a client and has determined that the client's body mass index (BMI) is 33.5 kg/m2. What health promotion advice should the nurse provide to the client?

• A. It would be very helpful if you could integrate more physical activity into your routine.
• B. You're considered to be overweight, so you should be diligent about maintaining a healthy diet.
• C. You might want to consider some of the surgical options that have been developed for treating obesity.
• D. With your permission, I'd like you to refer to a support group for individuals who live with severe obesity.

Correct answer: A

Rationale: Increasing physical activity is a key component of managing BMI and overall health.

2. A client with a history of atrial fibrillation is prescribed dabigatran (Pradaxa). Which instruction should the nurse include in the client's teaching?

• A. Take the medication with food to improve absorption.
• B. Avoid foods high in vitamin K.
• C. Take the medication at the same time each day.
• D. Increase your intake of high-potassium foods.

Correct answer: C

Rationale: The correct instruction for the nurse to include in the client's teaching regarding dabigatran (Pradaxa) is to take the medication at the same time each day. This ensures a consistent blood level and effectiveness of the medication, which is crucial in managing atrial fibrillation and preventing complications. It helps maintain a steady therapeutic effect and reduces the risk of erratic drug levels in the body.

3. After a client with ascites due to liver cirrhosis undergoes a paracentesis, what should the nurse do post-procedure?

• A. Encourage the client to drink plenty of fluids
• B. Monitor the client's blood pressure and heart rate
• C. Position the client flat on their back
• D. Administer a dose of furosemide

Correct answer: B

Rationale: Post-paracentesis, monitoring the client's blood pressure and heart rate is crucial as it helps in early detection of potential complications such as hypotension or bleeding. This close observation enables timely intervention and ensures the client's safety.

4. A client who participates in a health maintenance organization (HMO) needs a bone marrow transplant for the treatment of breast cancer. The client tells the nurse that she is concerned that her HMO may deny her claim. What action by the nurse best addresses the client's need at this time?

• A. Have the client's healthcare provider write a letter to the HMO explaining the need for the transplant.
• B. Help the client place a call to the HMO to seek information about limitations of coverage.
• C. Encourage the client to contact a lawyer to file a lawsuit against the HMO if necessary.
• D. Have the social worker contact the state board of insurance to register a complaint against the HMO.

Correct answer: B

Rationale: The best action for the nurse to take in this situation is to help the client directly contact the HMO to seek information about limitations of coverage. This approach addresses the client's immediate concerns and clarifies the situation, enabling the client to understand the coverage and potential outcomes regarding the bone marrow transplant. Choice A is not the best option as having the healthcare provider write a letter may not provide immediate clarification on coverage. Choice C is inappropriate as legal action should be considered as a last resort, and choice D involving the state board of insurance is not necessary at this initial stage of addressing the client's concern.

5. The client is prescribed clozapine (Clozaril), and the nurse plans to educate them about its purpose. Which statement should the nurse provide?

• A. It will help you function better in the community.
• B. The medication will help you think more clearly.
• C. You will be able to cope with your symptoms.
• D. It will improve your grooming and hygiene.

Correct answer: B

Rationale: Clozapine (Clozaril) is an antipsychotic medication that is known to improve cognitive function and thought clarity in individuals with schizophrenia. It primarily helps in managing symptoms related to thought processes rather than focusing on community function, coping with symptoms, or grooming and hygiene.

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