Nursing Elites

1. After undergoing gastric resection, the client is informed by the nurse that which of the following meals is most likely to cause rapid emptying of the stomach?

• A. a high-protein meal
• B. a high-fat meal
• C. a large meal regardless of nutrient content
• D. a high-carbohydrate meal

Correct answer: D

Rationale: After gastric resection, meals high in carbohydrates are more likely to cause rapid emptying of the stomach. Carbohydrates stimulate the release of gastrin, which accelerates gastric emptying. On the other hand, high-fat and high-protein meals tend to delay gastric emptying. A large meal, regardless of nutrient content, can also delay gastric emptying due to the increased volume of food that needs to be processed.

2. What instruction should a client who is about to undergo pelvic ultrasonography be given by a healthcare provider?

• A. "Urinate prior to the test."?
• B. "Have someone drive you home."?
• C. "Do not drink after midnight."?
• D. "Drink plenty of water."?

Correct answer: D

Rationale: The correct instruction for a client about to undergo pelvic ultrasonography is to 'Drink plenty of water.' A full bladder is required to serve as a landmark to define pelvic organs during the procedure. It is important to ensure the bladder is adequately filled. 'Urinate prior to the test' (Choice A) would not be appropriate as a full bladder is needed for better visualization. 'Have someone drive you home' (Choice B) is unnecessary as no sedation is given during the procedure, so the client can drive home on their own. 'Do not drink after midnight' (Choice C) is unrelated and not necessary for a pelvic ultrasonography examination.

3. Which of the following clients requires airborne precautions?

• A. a client with fever, chills, vomiting, and diarrhea
• B. a client suspected of varicella (chickenpox)
• C. a client with abdominal pain and purpura
• D. a client diagnosed with AIDS

Correct answer: B

Rationale: The correct answer is 'a client suspected of varicella (chickenpox).' Chickenpox is an acute, infectious airborne illness that requires airborne precautions, including wearing a respirator mask for direct contact with the patient. Choices A, C, and D do not typically require airborne precautions. Choice A describes symptoms that may indicate a gastrointestinal infection but do not require airborne precautions. Choice C mentions abdominal pain and purpura, which are not specific to an airborne illness. Choice D, a client diagnosed with AIDS, does not necessitate airborne precautions unless there are additional infectious conditions present that require such measures.

4. An advance directive is written and notarized according to law in the state of Colorado. This document is legal and binding:

• A. internationally.
• B. in the state of Colorado only.
• C. in the continental United States.
• D. in the county of origination only.

Correct answer: B

Rationale: The correct answer is 'in the state of Colorado only.' Advance directive protocols and documents are specific to each state's laws and regulations. Choice A is incorrect as advance directives are not universally recognized internationally. Choice C is incorrect as the legal validity of an advance directive is limited to the state in which it was created. Choice D is incorrect as the legal reach of an advance directive typically extends throughout the state of origination, not just the county.

5. When managing time effectively, which of the following stimuli should the nurse respond to first?

• A. the physician's loud verbal direction
• B. the nursing supervisor who is going to a meeting
• C. unit staff leaving on a break
• D. the care needs of the returning postoperative client just exiting the elevator

Correct answer: D

Rationale: The correct answer is to attend to the care needs of the returning postoperative client just exiting the elevator first. In a healthcare setting, patient care should always take precedence, especially for complex or unstable clients requiring immediate assessment and care. The physician's loud verbal direction, the nursing supervisor going to a meeting, and unit staff leaving on a break are important but do not involve direct patient care. Therefore, the nurse should prioritize responding to the returning postoperative client to ensure their immediate needs are met.

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