Nursing Elites

1. A 32-year-old female client complains of severe abdominal pain each month before her menstrual period, painful intercourse, and painful defecation. Which additional history should the nurse obtain that is consistent with the client's complaints?

• A. Frequent urinary tract infections.
• B. Inability to get pregnant.
• C. Premenstrual syndrome.
• D. Chronic use of laxatives.

Correct answer: B

Rationale: The correct answer is B: 'Inability to get pregnant.' The symptoms described in the client's complaints, which include severe abdominal pain before menstruation, painful intercourse, and painful defecation, are indicative of endometriosis. Endometriosis is a condition characterized by the abnormal presence of endometrial tissue outside the uterus, commonly leading to infertility. While choices A, C, and D may be associated with other conditions, they are not directly related to the symptoms described by the client, making them incorrect choices. Frequent urinary tract infections may suggest a different issue, premenstrual syndrome does not typically present with severe abdominal pain, and chronic use of laxatives is not a typical symptom of endometriosis.

2. The nurse is caring for a patient who will receive 10% calcium gluconate to treat a serum potassium level of 5.9 mEq/L. The nurse performs a drug history prior to beginning the infusion. Which drug taken by the patient would cause concern?

• A. Digitalis
• B. Hydrochlorothiazide
• C. Hydrocortisone
• D. Vitamin D

Correct answer: A

Rationale: Calcium gluconate is administered to treat hyperkalemia by reducing myocardial irritability. When given to a patient taking digitalis, it can lead to digitalis toxicity. Digitalis and calcium gluconate both affect cardiac function, and their concomitant use can potentiate adverse effects. Hydrochlorothiazide, Hydrocortisone, and Vitamin D may impact potassium levels, but they do not interact with calcium gluconate in a way that would cause concern for toxicity.

3. Assessment of the diabetic client for common complications should include examination of the:

• A. Abdomen.
• B. Lymph glands.
• C. Pharynx.
• D. Eyes.

Correct answer: D

Rationale: The correct answer is D: Eyes. Diabetic clients are at high risk of developing complications such as diabetic retinopathy, making regular eye examinations crucial. Assessing the eyes helps in early detection and management of diabetic eye diseases. Choices A, B, and C are incorrect because while they may be relevant in certain assessments, they are not commonly associated with complications specific to diabetes. Examination of the abdomen, lymph glands, and pharynx are not typically part of routine assessments for common complications in diabetic clients.

4. What discharge instruction is most important for a client after a kidney transplant?

• A. Weigh weekly.
• B. Report symptoms of secondary Candidiasis.
• C. Use daily reminders to take immunosuppressants.
• D. Stop cigarette smoking.

Correct answer: C

Rationale: After a kidney transplant, it is crucial for the client to adhere to the prescribed immunosuppressive therapy to prevent organ rejection. The client must take medications like corticosteroids and azathioprine (Imuran) regularly for the rest of their life. Using daily reminders is essential to ensure compliance with the medication regimen, as missing doses can increase the risk of organ rejection. Weighing weekly, reporting symptoms of secondary Candidiasis, and stopping cigarette smoking are important aspects of post-transplant care but may not be as critical as ensuring proper intake of immunosuppressants to prevent rejection.

5. What is the primary nursing intervention for a patient experiencing an acute asthma attack?

• A. Administering bronchodilators.
• B. Administering antibiotics.
• C. Administering IV fluids.
• D. Administering corticosteroids.

Correct answer: A

Rationale: The correct answer is administering bronchodilators. During an acute asthma attack, the primary goal is to relieve airway constriction and bronchospasm to improve breathing. Bronchodilators, such as short-acting beta-agonists, are the cornerstone of treatment as they help dilate the airways quickly. Administering antibiotics (choice B) is not indicated unless there is an underlying bacterial infection. Administering IV fluids (choice C) may be necessary in some cases, but it is not the primary intervention for an acute asthma attack. Administering corticosteroids (choice D) is often used as an adjunct therapy to reduce airway inflammation, but it is not the primary intervention during the acute phase of an asthma attack.

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