Nursing Elites

1. What intervention would be the most important for the nurse to implement for the client with a left nephrectomy?

• A. Assess the intravenous fluids for rate and volume
• B. Change the surgical dressing every day at the same time
• C. Monitor the client’s medication levels daily
• D. Monitor the percentage of each meal eaten

Correct answer: A

Rationale: The most important intervention for a client with a left nephrectomy is to assess the intravenous fluids for rate and volume. After nephrectomy, monitoring intravenous fluids is crucial to ensure proper hydration and kidney function. Changing the surgical dressing daily, monitoring medication levels, and tracking meal intake are also important aspects of care but not as critical as ensuring adequate intravenous fluid management post-surgery.

2. Listed below are five categories that identify the responsibilities of the practical nurse manager in personnel management. Which of these categories is most appropriate for the task of 'Ensuring that soldiers are utilized in their MOS'?

• A. Accountability
• B. Personal/professional development
• C. Individual training
• D. Military appearance/physical condition

Correct answer: A

Rationale: The correct answer is 'Accountability.' Accountability involves ensuring that individuals are utilized effectively in their assigned roles, which aligns with the task of 'Ensuring that soldiers are utilized in their MOS.' Personal/professional development (choice B) focuses on personal growth and skill enhancement rather than role utilization. Individual training (choice C) pertains to specific skill development rather than overall role utilization. Military appearance/physical condition (choice D) relates to physical fitness and appearance standards, not role assignments.

3. The nurse is caring for the client one day postoperative sigmoid colostomy operation. Which independent nursing intervention should the nurse implement?

• A. Change the infusion rate of the intravenous fluid
• B. Encourage the client to discuss his or her feelings
• C. Administer opioid narcotic medications for pain management
• D. Assist the client out of bed to sit in the chair twice daily

Correct answer: D

Rationale: Assisting the client to sit in a chair is an essential nursing intervention postoperatively as it helps promote circulation, prevent complications like blood clots, and aids in the recovery process. Changing the infusion rate of intravenous fluid (Choice A) requires a physician's order and is not an independent nursing intervention. Encouraging the client to discuss feelings (Choice B) is important for emotional support but not as crucial as physical care immediately postoperatively. Administering opioid narcotic medications (Choice C) for pain management should be based on a prescribed schedule and assessment rather than being an independent nursing action.

4. The nurse is caring for the client recovering from a percutaneous renal biopsy. Which data indicate that the client is complying with client teaching?

• A. The client lies flat in the supine position for 12 hours
• B. The client continues oral fluids restriction while on bed rest
• C. The client’s family changed the dressing on return to the room
• D. The family activates the patient-controlled analgesia pump

Correct answer: A

Rationale: The correct answer is A. Lying flat in the supine position for 12 hours after a renal biopsy is essential to prevent bleeding and promote recovery. This position helps apply pressure to the biopsy site, reducing the risk of bleeding. Choices B, C, and D are incorrect because continuing oral fluids restriction, changing the dressing, and activating the patient-controlled analgesia pump do not directly indicate compliance with the crucial post-biopsy teaching of maintaining the supine position.

5. Which discharge instruction should the nurse teach the client diagnosed with varicose veins who has received sclerotherapy?

• A. Walk 15 to 20 minutes three (3) times a day.
• B. Keep the legs in the dependent position when sitting.
• C. Remove compression bandages before going to bed.
• D. Perform Berger-Allen exercises (4) times a day.

Correct answer: A

Rationale: The correct answer is to instruct the client to walk 15 to 20 minutes three times a day. Walking is beneficial as it helps improve circulation and reduces the risk of complications following sclerotherapy. Choice B is incorrect because keeping the legs in the dependent position when sitting can lead to increased venous pressure, worsening varicose veins. Choice C is incorrect as compression bandages should typically be worn continuously, especially during the initial healing phase. Choice D is incorrect as Berger-Allen exercises are not commonly associated with post-sclerotherapy care.

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