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 66-year-old woman is retiring and needs health insurance. To which agency should the employee health nurse refer her?

• A. Medicaid
• B. Medicare
• C. COBRA
• D. Private insurance

Correct answer: B

Rationale: The correct answer is B: Medicare. Medicare is the federal health insurance program for individuals aged 65 and older, so it is the most suitable option for the 66-year-old woman retiring. Medicaid (choice A) is a state and federally funded program for low-income individuals and families, not specifically for retirees. COBRA (choice C) allows employees to continue their employer-sponsored health insurance for a limited time after leaving employment. Private insurance (choice D) refers to health insurance plans purchased directly from private insurance companies.

3. An older client with a long history of coronary artery disease, HTN, and HF arrives in the ED in respiratory distress. The healthcare provider prescribes furosemide IV. Which therapeutic response to furosemide should the nurse expect in the client with acute HF?

• A. Decreased heart rate
• B. Improved blood pressure
• C. Increased urine output
• D. Reduced preload

Correct answer: D

Rationale: The correct answer is D: Reduced preload. Furosemide is a diuretic that reduces fluid overload in heart failure, which lowers the preload (the volume of blood in the ventricles before contraction). By reducing this volume, furosemide improves symptoms of heart failure. While furosemide may lead to increased urine output and lower blood pressure, these effects are secondary to the reduction in preload. Decreased heart rate is not a direct effect of furosemide in heart failure.

4. The nurse is providing education to a client who experiences recurrent levels of moderate anxiety in response to situations and perceived stress. In addition to information about prescribed medication and administration, which instruction should the nurse include in the teaching?

• A. Practice using muscle relaxation techniques
• B. Take medication only when anxiety is at its worst
• C. Avoid interactions that trigger stress
• D. Engage in exercise during anxious periods

Correct answer: A

Rationale: Teaching relaxation techniques, such as muscle relaxation, helps the client manage anxiety more effectively. These techniques can be practiced regularly to reduce overall anxiety and can complement prescribed medications. Choice B is incorrect because medication should be taken as prescribed, not only when anxiety is at its worst. Choice C is incorrect as avoiding interactions that trigger stress may not always be feasible and does not teach the client coping mechanisms. Choice D is incorrect as engaging in exercise during anxious periods may not be the most effective strategy for managing moderate anxiety levels.

5. The nurse is teaching a group of clients about managing diabetes. Which of the following should be emphasized as a goal for all diabetics?

• A. Frequent exercise and weight control
• B. Prevent eye damage
• C. Keep insulin refrigerated at all times
• D. Prevent the development of complications

Correct answer: A

Rationale: The correct answer is A: Frequent exercise and weight control. These should be emphasized as a goal for all diabetics because they help prevent complications and manage blood sugar levels. Regular physical activity and maintaining a healthy weight are crucial in managing diabetes as they can improve insulin sensitivity, regulate blood sugar levels, and reduce the risk of cardiovascular complications. Choice B, preventing eye damage, is important but is more specific to diabetic retinopathy and not a general goal for all diabetics. Choice C, keeping insulin refrigerated, is essential for insulin storage but not a primary goal for all diabetics. Choice D, preventing the development of complications, is too broad and does not provide a specific actionable goal for all diabetics.

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