Nursing Elites

1. A patient with stage I nonsmall cell lung cancer expresses a preference for chemotherapy over surgery. Which response by the nurse is most appropriate?

• A. Are you concerned about the potential pain from surgery?
• B. Have you had negative experiences with previous surgeries?
• C. Surgery is the recommended treatment for stage I lung cancer.
• D. Tell me about your understanding of the different available treatments.

Correct answer: Tell me about your understanding of the different available treatments.

Rationale: The most appropriate response by the nurse in this situation is to gather more information about the patient's concerns and preferences. By asking the patient to share their understanding of the available treatments, the nurse encourages open communication and gains insight into the patient's knowledge and preferences. Option A focuses solely on pain, which may not be the patient's primary concern. Option B assumes negative experiences without exploring the patient's current thoughts. Option C, stating that surgery is the recommended treatment, dismisses the patient's preference and does not address their concerns. Chemotherapy is not the primary treatment for nonsmall cell lung cancer; it may be used for nonresectable tumors or as adjuvant therapy to surgery, making it crucial for the nurse to explore the patient's treatment preferences and understanding.

2. Signs and symptoms of stroke may include all of the following EXCEPT:

• A. Sudden weakness or numbness of the face, arm, or leg.
• B. Sudden confusion.
• C. Sudden headache with no known cause.
• D. Hypotension.

Correct answer: Hypotension.

Rationale: Hypotension is not a typical sign or symptom of an acute stroke. The correct signs and symptoms of a stroke include sudden weakness or numbness of the face, arm, or leg, sudden confusion, and a sudden headache with no known cause. Hypotension, which refers to low blood pressure, is not a common indicator of a stroke. It is important to differentiate between hypotension and hypertension in the context of stroke symptoms, as hypertension (high blood pressure) is actually a risk factor for strokes. Sudden weakness, numbness, confusion, and headache are signs associated with a stroke due to a disruption in blood flow to the brain. Hypotension, on the other hand, primarily indicates low blood pressure and is not directly linked to the typical presentation of a stroke.

3. The nurse is assigned to care for a child who is scheduled for an appendectomy. Select the prescriptions that the nurse anticipates will be prescribed. Select one that doesn't apply.

• A. Initiate an IV line.
• B. Maintain an NPO status.
• C. Administer a Fleet enema.
• D. Administer intravenous antibiotics.

Correct answer: Administer a Fleet enema.

Rationale: For a child scheduled for an appendectomy, the administration of a Fleet enema is not typically required. An IV line is often initiated for fluid and medication administration, maintaining NPO status is necessary to prevent aspiration during surgery, and administering intravenous antibiotics may be part of the preoperative regimen. Therefore, the correct choice that does not apply in this case is administering a Fleet enema.

4. What preparation should be made for a client undergoing a KUB (Kidney, Ureter, Bladder) radiography test?

• A. Client must be NPO before the examination
• B. Enema should be administered before the examination
• C. Medicate the client with furosemide 20 mg IV 30 minutes before the examination
• D. No special orders are necessary for this examination

Correct answer: No special orders are necessary for this examination

Rationale: The correct answer is that no special orders are necessary for a KUB radiography test. It is important to inform the client to remove any clothing, jewelry, or objects that may interfere with the test. Option A is incorrect because there is no need for the client to be NPO before this examination. Option B is incorrect as enemas are not routinely administered prior to a KUB radiography test. Option C is incorrect as there is no need to medicate the client with furosemide before this examination.

5. A 7-year-old child is seen in a clinic, and the pediatrician documents a diagnosis of nighttime (nocturnal) enuresis. What information should the nurse provide to the parents?

• A. Nighttime (nocturnal) enuresis does not respond to treatment.
• B. Nighttime (nocturnal) enuresis is caused by a psychiatric problem.
• C. Nighttime (nocturnal) enuresis requires surgical intervention to improve the problem.
• D. Nighttime (nocturnal) enuresis is usually outgrown without therapeutic intervention.

Correct answer: Nighttime (nocturnal) enuresis is usually outgrown without therapeutic intervention.

Rationale: Nighttime (nocturnal) enuresis is common in children and is characterized by a child who has never been dry at night for extended periods. Most children eventually outgrow bedwetting without therapeutic intervention. This condition is due to the child being unable to sense a full bladder and not awakening to void, often related to delayed maturation of the central nervous system. It is important for parents to understand that nighttime (nocturnal) enuresis is not caused by a psychiatric problem, does not typically require surgical intervention, and usually resolves on its own over time.

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