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. A client is transferred from the emergency department to the locked psychiatric unit after attempting suicide by taking 200 acetaminophen (Tylenol) tablets. The client is now awake and alert but refuses to speak with the nurse. In this situation, the nurse’s first priority is to:

• A. Establish a rapport to foster trust
• B. Place the client in full restraints
• C. Try to communicate with the client in writing
• D. Ensure safety by initiating suicide precautions

Correct answer: D

Rationale: In this scenario, the nurse's highest priority should be to ensure the client's safety by initiating suicide precautions. Given the history of a suicide attempt by taking a large number of acetaminophen tablets, there is a high risk of further self-harm. Placing the client in full restraints without assessing the situation properly may escalate anxiety and hinder therapeutic communication. Trying to communicate with the client in writing could be an option but ensuring immediate safety takes precedence. Establishing rapport is essential for building trust and therapeutic relationship, but safety concerns must be addressed first in this critical situation.

3. The system used at the division level and forward comprises six basic modules. Which module is composed of a dental officer, dental specialist, x-ray specialist, laboratory specialist, and needed equipment?

• A. Treatment squad
• B. Area support squad
• C. Medical service squad
• D. Dental squad

Correct answer: D

Rationale: The correct answer is D, the Dental squad. This squad is specifically composed of a dental officer, dental specialist, x-ray specialist, laboratory specialist, and necessary equipment. The other choices, A, B, and C, do not include the specific group of specialists mentioned in the question. Therefore, they are incorrect. The Treatment squad may involve a broader range of medical professionals, while the Area support squad and Medical service squad focus on different aspects of healthcare support not related to the dental field.

4. Which of the following is inappropriate in collecting mid stream clean catch urine specimen for urine analysis?

• A. Collect early in the morning, First voided specimen
• B. Do perineal care before specimen collection
• C. Collect 5 to 10 ml for urine
• D. Discard the first flow of the urine

Correct answer: A

Rationale: When collecting a mid-stream clean catch urine specimen for urine analysis, it is important to collect an adequate amount of urine for accurate testing. A volume of 30 to 60 ml is usually recommended for optimal results, so collecting only 5 to 10 ml would not provide enough urine for testing purposes. It is essential to follow proper collection techniques to ensure accurate and reliable test results.

5. A patient with a history of gout should avoid which type of food?

• A. Red meat
• B. Chicken
• C. Fish
• D. Dairy

Correct answer: A

Rationale: A patient with a history of gout should avoid foods high in purines, which can exacerbate gout attacks. Red meat is particularly high in purines, so it is the type of food that should be avoided. Chicken and fish are lower in purines compared to red meat, making them better choices for individuals with gout. Dairy products are generally not associated with triggering gout attacks, so they can be consumed in moderation by patients with gout.

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