Nursing Elites

1. The client is learning about lifestyle changes to manage hypertension. Which statement by the client requires further teaching?

• A. I will reduce my salt intake.
• B. I will exercise for 30 minutes most days of the week.
• C. I will drink alcohol only on the weekends.
• D. I will monitor my blood pressure regularly.

Correct answer: C

Rationale: The correct answer is C. Clients with hypertension should ideally avoid or limit alcohol intake rather than just restricting it to weekends. Excessive alcohol consumption can raise blood pressure and interfere with the effectiveness of hypertension management. Choices A, B, and D are all positive statements that align with managing hypertension: reducing salt intake, regular exercise, and monitoring blood pressure are all beneficial lifestyle changes for individuals with hypertension. Therefore, the statement about drinking alcohol only on weekends requires further teaching to emphasize the importance of reducing alcohol consumption for better blood pressure control.

2. A client is receiving chemotherapy for breast cancer. Which laboratory value would be most important for the nurse to monitor?

• A. White blood cell count
• B. Hemoglobin level
• C. Serum creatinine
• D. Blood glucose level

Correct answer: A

Rationale: The correct answer is to monitor the white blood cell count. Chemotherapy can lead to neutropenia, which is a decrease in white blood cells, particularly neutrophils. Neutropenia increases the risk of infections, making it crucial to monitor the white blood cell count during chemotherapy. Monitoring hemoglobin level is important but not as critical as white blood cell count in this scenario. Serum creatinine and blood glucose levels are not directly impacted by chemotherapy for breast cancer, making them less relevant to monitor in this situation.

3. A client scheduled for arthroplasty expresses concern about the risk of acquiring an infection from a blood transfusion. Which of the following statements should the nurse make to the client?

• A. Donate autologous blood before the surgery
• B. Request a specific blood type from the donor
• C. Use blood from a family member
• D. Accept allogeneic blood without concerns

Correct answer: A

Rationale: The correct statement for the nurse to make to the client is to 'Donate autologous blood before the surgery.' Autologous blood donation involves collecting and storing the client's own blood for potential use during surgery, which significantly reduces the risk of transfusion-related infections. This option directly addresses the client's concern about infection risk. Requesting a specific blood type from a donor (Choice B) is not as effective in reducing infection risk compared to autologous blood donation. Using blood from a family member (Choice C) carries the risk of transfusion reactions and infections due to compatibility issues. Accepting allogeneic blood without concerns (Choice D) does not address the client's specific concern about infection risk and is not the most appropriate option in this situation.

4. A client with a diagnosis of Methicillin-resistant Staphylococcus aureus (MRSA) has died. Which type of precautions is the appropriate type to use when performing postmortem care?

• A. Airborne precautions
• B. Droplet precautions
• C. Contact precautions
• D. Compromised host precautions

Correct answer: C

Rationale: Contact precautions are necessary when performing postmortem care on a client with MRSA to prevent the spread of infection. Contact precautions involve using barriers like gloves and gowns to limit direct contact with the deceased individual's body fluids and tissues. Airborne precautions are used for pathogens that are transmitted through the air, like tuberculosis. Droplet precautions are for pathogens that are transmitted through respiratory droplets, such as influenza. Compromised host precautions are not a recognized standard precaution type and are not applicable in this scenario.

5. A client in a provider’s office tells the nurse that, 'I fast for several days each week to help control my weight.' The client takes several medications for various chronic issues. The nurse should explain to the client that which of the following mechanisms that result from fasting puts her at risk for medication toxicity?

• A. Increasing the metabolism of the medications over time
• B. Increasing the protein-binding response
• C. Increasing medications’ transit time through the intestines
• D. Decreasing the excretion of medications

Correct answer: B

Rationale: Fasting can lead to an increased protein-binding response of medications. This can result in a higher concentration of bound medications in the bloodstream, potentially causing toxicity as the medications may not be readily available for metabolism or excretion. Choice A is incorrect because fasting typically doesn't increase medication metabolism. Choice C is incorrect as fasting usually decreases transit time through the intestines. Choice D is incorrect since fasting generally does not decrease medication excretion.

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