Nursing Elites

1. Which statement made by the client indicates an understanding of the instructions regarding the administration of alendronate (Fosamax)?

• A. I will take the medication at bedtime to avoid stomach upset.
• B. I will take the medication with a full glass of water first thing in the morning.
• C. I will lie down for 30 minutes after taking the medication.
• D. I will take the medication with food to reduce stomach irritation.

Correct answer: B

Rationale: The correct answer is B. Alendronate (Fosamax) should be taken with a full glass of water in the morning to prevent esophageal irritation and ensure proper absorption. Choice A is incorrect because taking alendronate at bedtime increases the risk of esophageal irritation due to lying down. Choice C is incorrect because patients should remain upright for at least 30 minutes after taking alendronate to prevent esophageal irritation. Choice D is incorrect because alendronate should be taken on an empty stomach, not with food, to enhance absorption.

2. A client with hypertension is prescribed a low-sodium diet. What is the most important instruction for the nurse to provide?

• A. Limit sodium intake to 2 grams per day.
• B. Choose fresh fruits and vegetables.
• C. Drink at least 8 glasses of water daily.
• D. Avoid processed foods and canned soups.

Correct answer: D

Rationale: The correct answer is D. Avoiding processed foods and canned soups is crucial for a client with hypertension on a low-sodium diet because these foods are typically high in sodium content. Fresh fruits and vegetables are generally healthy choices but may still contain some natural sodium. While limiting sodium intake to 2 grams per day is important, specifically avoiding processed foods and canned soups is more critical in this situation. Drinking water is essential for overall health but is not the most important instruction when focusing on reducing sodium intake.

3. The nurse is conducting intake interviews of children at a city clinic. Which child is most susceptible to lead poisoning?

• A. An 8-year-old who lives in a housing project.
• B. A 2-year-old who plays on aging playground equipment.
• C. An adolescent who works in a paint factory.
• D. A 10-year-old with Type 1 diabetes.

Correct answer: B

Rationale: The correct answer is B. Young children, like the 2-year-old playing on aging playground equipment, are at higher risk of lead poisoning due to their hand-to-mouth behavior and exploration of their environment. Aging playground equipment may have lead-based paint that can be ingested by the child. While children living in housing projects are also at risk due to lead-based paint in older buildings, the 2-year-old child playing on potentially lead-contaminated playground equipment is the most susceptible in this scenario. The adolescent working in a paint factory may face occupational hazards related to lead exposure, but the immediate risk from environmental sources is higher for the 2-year-old. Type 1 diabetes in a 10-year-old is not directly linked to an increased susceptibility to lead poisoning.

4. A client with dysphagia is having difficulty swallowing medications. What is the nurse's best intervention?

• A. Crush the medications and mix them with applesauce.
• B. Encourage the client to drink water with each dose.
• C. Consult with the healthcare provider about switching to liquid medications.
• D. Offer the client soft foods to reduce difficulty swallowing.

Correct answer: C

Rationale: The best intervention for a client with dysphagia experiencing difficulty swallowing medications is to consult with the healthcare provider about switching to liquid medications. Liquid medications are often easier to swallow and can reduce the risk of choking and aspiration in clients with dysphagia. Crushing medications can alter their effectiveness, encouraging the client to drink water may not be sufficient, and offering soft foods is not directly related to improving medication swallowing.

5. A client is experiencing angina at rest. Which statement indicates a good understanding of the care required?

• A. I will notify the nurse if my chest pain is not relieved in 30 minutes.
• B. I will use nitroglycerin as needed, every 5 minutes, up to 3 doses.
• C. I will avoid physical activity until the pain subsides completely.
• D. I will take nitroglycerin 30 minutes before any physical activity.

Correct answer: B

Rationale: The correct answer is B. Using nitroglycerin as needed, every 5 minutes, up to 3 doses, is the appropriate management for angina at rest. This helps dilate blood vessels, improving blood flow to the heart. Choice A is incorrect because chest pain that persists at rest should be addressed immediately, not waiting for 30 minutes. Choice C is incorrect as avoiding physical activity is not a recommended approach during an angina episode. Choice D is incorrect because nitroglycerin should be used during chest pain episodes, not as a preventive measure before physical activity.

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