Nursing Elites

1. After a client has a tubal ligation in the outpatient surgical clinic, what is the priority for the nurse to determine?

• A. The client's prior experiences with outpatient surgery
• B. The client's medical plan and the extent of coverage for outpatient surgery
• C. The client's plan for transportation and care at home
• D. The client's plan to spend the night at the surgical center

Correct answer: C

Rationale: The priority for the nurse is to ensure the client has a safe way to get home and adequate care after discharge. It is crucial to determine the client's transportation arrangements and availability of care at home to ensure a smooth transition postoperatively. Options A and B, though important, are not immediate priorities compared to the client's safety and well-being after the procedure. Option D is incorrect as spending the night at the surgical center is not typically part of the plan for outpatient surgery.

2. A client had a Caesarean delivery and is postpartum day 1. She asks for pain medication when the nurse enters the room to do her shift assessment. The client states that her pain level is an 8 on a scale of 1 to 10. What should be the nurse's priority of care?

• A. Give the pain medication and return in an hour for further assessment to allow time for the medication to work.
• B. Complete the postpartum assessment and then give the client pain medication.
• C. Give the pain medication first, do a quick assessment while administering the medication to ensure the pain is not caused by a complication, and return for the full assessment after the client's pain has subsided.
• D. Instruct the patient to do relaxation exercises to relieve her discomfort.

Correct answer: C

Rationale: Pain management is a priority, so the nurse should immediately provide pain medication. However, the nurse should conduct a quick assessment while administering the medication to ensure that a complication, such as hemorrhage, hasn't caused the increased pain. A complete assessment can wait until the pain subsides. Controlling pain will enable the client to move, eliminating other potential complications of delivery and facilitating bonding with the infant. Relaxation techniques can act as an adjunct therapy but by themselves are not usually effective for pain management during the early post-Caesarean period.

3. What type of cells create exocrine secretions?

• A. alpha cells
• B. beta cells
• C. acinar cells
• D. plasma cells

Correct answer: C

Rationale: Acinar cells are responsible for creating exocrine secretions, such as enzymes and digestive juices. Alpha cells are found in the pancreas and are responsible for producing glucagon, beta cells produce insulin, and plasma cells are a type of white blood cell involved in immune responses. Therefore, the correct answer is acinar cells, as they specifically produce exocrine secretions.

4. High uric acid levels can develop in clients who are receiving chemotherapy. This can be caused by

• A. the kidneys' inability to excrete the drug metabolites.
• B. rapid cell catabolism.
• C. toxic effects of the prophylactic antibiotics given concurrently.
• D. the altered blood pH from the acidic nature of the drugs.

Correct answer: B

Rationale: The correct answer is 'rapid cell catabolism.' Chemotherapy leads to the destruction of cells, resulting in increased uric acid levels due to cell breakdown. Choice A is incorrect because the issue is not with the kidneys' ability to excrete the drug metabolites but rather with the cell breakdown. Choice C is incorrect as the question focuses on chemotherapy and its effects, not prophylactic antibiotics. Choice D is incorrect as the question pertains to the development of high uric acid levels, not altered blood pH from acidic drugs.

5. Which deficiency in the mother has been primarily associated with neural tube defects in the fetus?

• A. Iron
• B. Folic acid
• C. Vitamin B12
• D. Vitamin E

Correct answer: B

Rationale: Folic acid deficiency in the mother has been primarily associated with neural tube defects in the fetus. Folic acid is crucial for the development of the neural tube in the early stages of pregnancy. Its deficiency can lead to neural tube defects, such as spina bifida or anencephaly. Iron deficiency is not directly related to neural tube defects but can cause other complications in pregnancy. Vitamin B12 is important for neurological function but is not the primary cause of neural tube defects. Vitamin E deficiency is not associated with neural tube defects in the fetus.

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