Nursing Elites

1. A client is admitted with acute pyelonephritis. Which symptom should the nurse expect the client to report?

• A. Flank pain
• B. Pedal edema
• C. Hypotension
• D. Weight gain

Correct answer: A

Rationale: Flank pain is a classic symptom of acute pyelonephritis, which is a bacterial infection of the kidney. It occurs due to inflammation and irritation of the renal capsule, leading to pain in the flank region. Pedal edema (swelling in the feet and ankles) is more commonly associated with conditions like heart failure or kidney disease, not typically seen in acute pyelonephritis. Hypotension (low blood pressure) is a systemic symptom that may occur with severe infections but is not a specific hallmark of pyelonephritis. Weight gain is also not a typical symptom of acute pyelonephritis; instead, patients may experience weight loss due to decreased appetite and systemic effects of infection.

2. The client is receiving continuous bladder irrigation following a transurethral resection of the prostate (TURP). Which finding indicates that the bladder irrigation is effective?

• A. The client reports minimal pain and discomfort.
• B. The urine appears clear and free of clots.
• C. The client has no signs of infection.
• D. The client is able to void independently.

Correct answer: B

Rationale: The presence of clear urine free of clots is an indicator that the bladder irrigation is effective. This finding suggests that the irrigation is preventing clot formation and ensuring proper drainage, which is crucial after a TURP procedure. The client reporting minimal pain and discomfort (choice A) may be a positive sign but does not directly reflect the effectiveness of the bladder irrigation. The absence of infection signs (choice C) is important but not specific to evaluating the bladder irrigation. The client being able to void independently (choice D) is a good sign overall but does not specifically indicate the effectiveness of the bladder irrigation.

3. A healthcare provider is preparing to provide chest physiotherapy for a client who has left lower lobe atelectasis. Which of the following actions should the healthcare provider plan to take?

• A. Place the client in Trendelenburg's position.
• B. Position the client in an upright sitting position.
• C. Administer bronchodilators after the procedure.
• D. Perform chest percussion and vibration while the client is lying flat.

Correct answer: A

Rationale: Placing the client in Trendelenburg's position is the appropriate action when providing chest physiotherapy for a client with left lower lobe atelectasis. This position helps mobilize secretions from the lower lobes of the lungs, aiding in their clearance. Trendelenburg's position promotes drainage from the affected area. Positioning the client in an upright sitting position (Choice B) would not facilitate the drainage of secretions from the affected lobe. Administering bronchodilators after the procedure (Choice C) is not directly related to chest physiotherapy and the treatment of atelectasis. Performing chest percussion and vibration while the client is lying flat (Choice D) may not effectively target the lower lobes where the atelectasis is located.

4. A client with a history of peptic ulcer disease is admitted with abdominal pain. Which finding should the LPN/LVN report to the healthcare provider immediately?

• A. Positive bowel sounds
• B. Rebound tenderness
• C. Increased appetite
• D. Elevated temperature

Correct answer: D

Rationale: Elevated temperature is the correct finding to report immediately in a client with a history of peptic ulcer disease and abdominal pain. This could indicate a perforation or worsening of the condition, requiring prompt medical attention. Positive bowel sounds (Choice A) are a normal finding and not a cause for concern. Rebound tenderness (Choice B) is concerning but does not require immediate attention compared to an elevated temperature. Increased appetite (Choice C) is not a red flag symptom for peptic ulcer disease and can be considered a positive sign, not requiring immediate attention.

5. A nurse in a primary care clinic is assessing a client who has a history of herpes zoster. Which of the following findings suggests that the client has postherpetic neuralgia?

• A. Linear clusters of vesicles on the right shoulder.
• B. Purulent drainage from both eyes.
• C. Decreased white blood cell count.
• D. Report of continued pain following resolution of the rash.

Correct answer: D

Rationale: The correct answer is D: Report of continued pain following resolution of the rash. Postherpetic neuralgia is a complication of herpes zoster characterized by persistent pain that continues even after the rash has resolved. This pain can be severe and debilitating, affecting the quality of life of the individual. Choices A, B, and C are incorrect because linear clusters of vesicles on the right shoulder would suggest an active herpes zoster outbreak, purulent drainage from both eyes would indicate an eye infection unrelated to postherpetic neuralgia, and a decreased white blood cell count is not typically associated with postherpetic neuralgia.

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