Nursing Elites

1. When educating an obese client about nutritional needs and weight loss, which of the following should not be included?

• A. knowledge of food and food products
• B. development of a positive mental attitude
• C. adequate exercise
• D. starting a fast weight-loss diet

Correct answer: D

Rationale: When educating an obese client about nutritional needs and weight loss, it is important to cover factors such as knowledge of food and food products, the development of a positive mental attitude, and the importance of adequate exercise. These aspects contribute to a holistic approach to weight management. However, recommending the client to start a fast weight-loss diet should not be included. Fast weight-loss diets can be harmful, leading to health risks, nutrient deficiencies, and unsustainable outcomes. It is crucial to advocate for gradual, sustainable weight loss strategies to ensure long-term success and overall well-being. Therefore, starting a fast weight-loss diet is the least appropriate option among the choices provided.

2. When administering a nasal spray medication, what should the client do before the medication is administered?

• A. The client should blow their nose gently before the medication is administered.
• B. The medication should be sprayed into the nostril.
• C. The medication should be administered as the client inhales.
• D. The client should sit upright when the medication is administered.

Correct answer: A

Rationale: The correct answer is that the client should blow their nose gently before the medication is administered. This step helps clear the nasal passages, ensuring that the medication can reach its intended target. Choice B is incorrect as the nasal spray should be directed into the nostril, not just in front of the nose. Administering the medication as the client inhales (Choice C) is crucial to ensure proper delivery, as it helps the medication reach the desired areas. Choice D is incorrect because the client should be sitting upright, not lying flat, when administering nasal spray medication to allow for better absorption and prevent the medication from flowing out.

3. When performing an eye examination, which area can a healthcare provider best visualize using an ophthalmoscope?

• A. Iris
• B. Cornea
• C. Optic disc
• D. Conjunctiva

Correct answer: C

Rationale: An ophthalmoscope is a tool used to visualize the internal structures of the eye during an examination. The optic disc, located on the internal surface of the retina, can be best visualized using an ophthalmoscope. The iris, cornea, and conjunctiva are superficial structures that can be examined without the need for an ophthalmoscope. Therefore, the correct answer is the optic disc. Choices A, B, and D are incorrect because they are external structures that can be examined directly without the use of an ophthalmoscope.

4. The nurse is assessing an 18-month-old. Which of these statements made by the parent or caregiver would require follow-up?

• A. I'm worried that my child is not using two-word phrases yet.
• B. My child has recently taken a few steps but does not seem stable when standing.
• C. My child seems to have developed separation anxiety when I leave.
• D. I'm letting my child use a spoon to eat.

Correct answer: B

Rationale: The correct answer is 'My child has recently taken a few steps but does not seem stable when standing.' By 18 months of age, children should have taken their first steps and stand well. If a child hasn't made progress by this age, a physical therapy evaluation may be necessary. It is normal for an 18-month-old to start using a spoon to eat. However, the use of two-word phrases is not typically expected until 2 years of age. Separation anxiety is a common developmental phase that typically occurs between 6 and 18 months, so it does not require immediate follow-up. Therefore, the statement about the child not being stable when standing raises a red flag and necessitates further evaluation.

5. The LPN on shift notices a client coming into the clinic with bruises on his arm. The client seems very afraid and doesn't speak much, which concerns the nurse because these are signs of physical abuse. The nurse should ____.

• A. use therapeutic communication to talk to the client and offer support while reporting the findings to the appropriate authorities based on the state requirements and protocols
• B. report the findings to the appropriate authorities based on the state requirements and protocols
• C. ignore the bruises, as this is not why the client is being treated and is not appropriate for the nurse to address
• D. report the suspected abuse to another nurse and collaborate on how to handle it

Correct answer: B

Rationale: In cases of suspected abuse, healthcare providers have a legal and ethical obligation to report such incidents to the relevant authorities. This not only ensures the safety and well-being of the client but also helps in preventing further harm. Option A is incorrect as attempting to gather evidence of abuse may interfere with the official investigation and is not the nurse's role. Offering support is crucial, but the priority is to report the findings to the appropriate authorities. Option C is incorrect as ignoring signs of abuse goes against the duty of a healthcare provider to protect their clients. Option D is incorrect as reporting suspected abuse to other nurses without involving the appropriate authorities may delay necessary actions and intervention.

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