Nursing Elites

1. A client is scheduled for a colonoscopy. Which of these instructions should the nurse provide?

• A. You should avoid eating or drinking anything after midnight the day before the test.
• B. You may have a light breakfast the morning of the test.
• C. You will need to drink a bowel preparation solution the day before the test.
• D. You will need to avoid taking any medications the day before the test.

Correct answer: C

Rationale: The correct answer is C: 'You will need to drink a bowel preparation solution the day before the test.' Before a colonoscopy, it is essential to cleanse the colon thoroughly by drinking a bowel preparation solution. This helps to ensure that the colon is clear for the procedure, allowing for better visualization and examination of the colon. Choices A, B, and D are incorrect because avoiding eating or drinking after midnight, having a light breakfast, and avoiding medications are not specific instructions related to the colonoscopy preparation process.

2. A nurse is caring for a client who has type 1 diabetes mellitus. Which of the following should the nurse recommend to the client as an appropriate sweetener?

• A. Corn syrup
• B. Natural honey
• C. Nonnutritive sugar substitute
• D. Agave nectar

Correct answer: C

Rationale: Nonnutritive sugar substitutes are suitable for individuals with diabetes, such as type 1 diabetes mellitus, as they do not affect blood glucose levels. Corn syrup and agave nectar contain high levels of sugar that can spike blood glucose levels, making them unsuitable for diabetes management. While natural honey is a natural sweetener, it can still impact blood sugar levels and is not the optimal choice for individuals with diabetes.

3. A client diagnosed with cirrhosis of the liver and ascites is receiving Spironolactone (Aldactone). The nurse understands that this medication spares the elimination of which element?

• A. Sodium
• B. Potassium
• C. Phosphate
• D. Albumin

Correct answer: B

Rationale: The correct answer is B: Potassium. Spironolactone is a potassium-sparing diuretic, which means it helps retain potassium while eliminating sodium. This is beneficial for patients with cirrhosis and ascites as they are at risk of low potassium levels. Choice A, Sodium, is incorrect as Spironolactone does not spare the elimination of sodium but rather helps eliminate it. Choice C, Phosphate, is incorrect as Spironolactone does not directly affect phosphate levels. Choice D, Albumin, is incorrect as Spironolactone does not spare the elimination of albumin.

4. During a physical assessment on a client who just had an endotracheal tube inserted, which finding would call for immediate action by the nurse?

• A. Breath sounds are auscultated bilaterally
• B. Mist is visible in the T-Piece
• C. Pulse oximetry of 88%
• D. Client is unable to speak

Correct answer: C

Rationale: A pulse oximetry reading of 88% indicates hypoxemia, which requires immediate intervention to ensure adequate oxygenation. In this scenario, the priority is to address the low oxygen saturation to prevent further complications. Auscultation of bilateral breath sounds is a positive finding as it indicates air entry into both lungs. Mist in the T-piece is expected in clients with an endotracheal tube, and the inability to speak is common due to the tube's placement.

5. The nurse is assessing a client 2 hours postoperatively after a femoral popliteal bypass. The upper leg dressing becomes saturated with blood. The nurse's first action should be to

• A. Wrap the leg with elastic bandages
• B. Apply pressure at the bleeding site
• C. Reinforce the dressing and elevate the leg
• D. Remove the dressings and re-dress the incision

Correct answer: B

Rationale: In this scenario where the upper leg dressing becomes saturated with blood post-femoral popliteal bypass, the nurse's first action should be to apply pressure at the bleeding site. Applying pressure is essential to control hemorrhage and prevent further blood loss. Choice A is incorrect as wrapping the leg with elastic bandages would not address the immediate issue of controlling the bleeding. Choice C is incorrect because reinforcing the dressing and elevating the leg should come after controlling the bleeding. Choice D is incorrect as removing the dressings and re-dressing the incision should only be done after the bleeding is under control to prevent excessive blood loss.

Similar Questions