Nursing Elites

1. The nurse instructs a client 5 days after a lumbar laminectomy with spinal fusion about how to move from a supine position to standing at the left side of the bed with a walker. Which of the following directions by the nurse is BEST?

• A. Raise the head of the bed so you are sitting straight up, bend your knees, and swing your legs to the side and then to the floor
• B. Rock your body from side to side, going further each time until you build up enough momentum to be lying on your right side, and then raise your trunk toward your toes
• C. Reach over to the left side rail with your right hand, pull your body onto its side, bend your upper leg so the foot is on the bed, and push down to elevate your trunk
• D. Focus on using your arms, the left elbow as a pivot with the left hand grasping the mattress edge and the right hand pushing on the mattress above the elbow, then slide your legs over the side of the mattress

Correct answer: C

Rationale: Choice C is the best direction provided by the nurse. This method involves reaching over to the left side rail with the right hand, pulling the body onto its side, bending the upper leg so the foot is on the bed, and pushing down to elevate the trunk. This approach helps maintain spinal alignment while moving from a lying to a standing position, reducing strain on the back. Choices A, B, and D involve movements that are not suitable for a client recovering from a lumbar laminectomy with spinal fusion and could potentially cause harm or discomfort.

2. What is the correct amount of specimen to collect when collecting a stool specimen for testing purposes?

• A. The nurse scoop the specimen specifically at the site
• B. She took around 1 inch of specimen or a teaspoonful
• C. Ask the client to call her for the specimen after the
• D. Ask the client to defecate in a bedpan, Secure a

Correct answer: B

Rationale: When collecting a stool specimen, the nurse should usually take about 1 inch of the specimen or a teaspoonful for testing purposes. This amount is sufficient for laboratory analysis and helps ensure accurate results. It is important for the nurse to follow the proper procedure for specimen collection to maintain accuracy in diagnostic testing. Choices A, C, and D are incorrect because they do not provide the correct information on the amount of specimen needed for stool specimen collection.

3. A patient with chronic renal failure should avoid which of the following?

• A. Potassium
• B. Calcium
• C. Iron
• D. Zinc

Correct answer: A

Rationale: Patients with chronic renal failure should avoid potassium due to impaired kidney function. The kidneys may not effectively filter excess potassium from the blood, leading to hyperkalemia. Calcium, iron, and zinc do not need to be avoided specifically in chronic renal failure unless there are other underlying reasons or complications.

4. A patient with diabetes should be advised to avoid which type of carbohydrate?

• A. Simple carbohydrates
• B. Complex carbohydrates
• C. Fiber-rich carbohydrates
• D. All carbohydrates

Correct answer: A

Rationale: A patient with diabetes should be advised to avoid simple carbohydrates. Simple carbohydrates can cause rapid spikes in blood glucose levels due to their quick absorption, which can be challenging to manage for individuals with diabetes. Complex carbohydrates and fiber-rich carbohydrates are generally better choices for individuals with diabetes as they are absorbed more slowly, leading to more stable blood glucose levels. Avoiding all carbohydrates is not necessary or recommended, as carbohydrates are an essential source of energy and nutrients in a balanced diet.

5. When is Aspirin most effective when taken?

• A. On an empty stomach with cold water
• B. On a full stomach after a meal
• C. With a glass of fruit juice
• D. First thing in the morning

Correct answer: A

Rationale: Aspirin is best absorbed on an empty stomach to maximize its effectiveness. Taking it with cold water helps to enhance absorption. Choice B is incorrect as taking aspirin on a full stomach may reduce its absorption. Choice C is incorrect as fruit juice can sometimes interact with medications. Choice D is incorrect as taking aspirin first thing in the morning may not optimize its absorption.

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