Nursing Elites

1. After undergoing rigid fixation for a mandibular fracture from a fight, what area of care should the nurse prioritize for discharge education for this client?

• A. Resumption of activities of daily living
• B. Pain control
• C. Promotion of adequate nutrition
• D. Strategies for promoting adequate nutrition

Correct answer: C

Rationale: The correct answer is promoting adequate nutrition. Following rigid fixation for a mandibular fracture, the client may have limitations in jaw movement, which can affect their ability to eat properly. Prioritizing education on promoting adequate nutrition will help ensure the client's nutritional needs are met during the recovery period.

2. The patient has a calcium level of 12.1 mg/dL. Which nursing action should the nurse include on the care plan?

• A. Maintain the patient on bed rest.
• B. Auscultate lung sounds every 4 hours.
• C. Monitor for Trousseau's and Chvostek's signs.
• D. Encourage fluid intake up to 4000 mL every day.

Correct answer: D

Rationale: The correct action for the nurse to include on the care plan for a patient with a calcium level of 12.1 mg/dL is to encourage fluid intake up to 4000 mL every day. This is essential to decrease the risk for renal calculi associated with hypercalcemia. While bed rest is not necessary, ambulation is encouraged to help decrease the loss of calcium from the bone. Monitoring for Trousseau's and Chvostek's signs is more relevant when hypocalcemia is suspected. Auscultating lung sounds every shift is a routine assessment, not required every 4 hours unless there is a specific respiratory concern.

3. A client with peptic ulcer disease is prescribed ranitidine (Zantac). Which statement by the client indicates the need for further teaching?

• A. I will take this medication at bedtime.
• B. I need to avoid smoking while taking this medication.
• C. I should take this medication with meals.
• D. This medication will help reduce stomach acid.

Correct answer: C

Rationale: The client's statement that they should take ranitidine with meals indicates a need for further teaching. Ranitidine is typically taken at bedtime or before meals to be most effective in reducing stomach acid. Taking it with meals may not provide the optimal therapeutic effect.

4. When should surgical correction of hypospadias typically occur for a newborn infant as advised by the nurse?

• A. Repair should be done within one month to prevent bladder infections.
• B. Repairs should typically be done before the child is potty-trained.
• C. Delaying the repair until school age reduces castration fears.
• D. To form a proper urethra repair, it should be done after sexual maturity.

Correct answer: B

Rationale: Surgical repair of hypospadias is recommended to be performed before the child is potty-trained to prevent complications. Early correction helps in achieving better outcomes and reduces the risk of issues related to urination and development of the genitalia.

5. After performing a paracentesis on a client with ascites, 3 liters of fluid are removed. Which assessment parameter is most critical for the nurse to monitor following the procedure?

• A. Pedal pulses.
• B. Breath sounds.
• C. Gag reflex.
• D. Vital signs.

Correct answer: D

Rationale: Following a paracentesis where a significant amount of fluid is removed, it is crucial to monitor the client's vital signs. This helps in detecting any signs of hypovolemia, such as changes in blood pressure, heart rate, and respiratory rate, which could indicate complications post-procedure. Monitoring the vital signs allows for prompt intervention if there are any deviations from the baseline values.

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