Nursing Elites

1. Before a client undergoes a Magnetic Resonance Imaging (MRI) scan with contrast, what should the nurse assess?

• A. If the client has any metal implants
• B. If the client has allergies to iodine or shellfish
• C. If the client has a history of claustrophobia
• D. If the client has ever had a similar procedure before

Correct answer: A

Rationale: Before an MRI scan with contrast, the nurse should assess if the client has any metal implants. Metal implants can interfere with the magnetic field of the MRI, which can pose a risk to the client's safety and compromise the quality of the scan. Assessing for allergies to iodine or shellfish (Choice B) is important for contrast agents but not specific to metal implants. Claustrophobia assessment (Choice C) is relevant for MRI scans due to the confined space but not specific to metal implants. Past procedures (Choice D) are important for comparison but not directly related to the risks associated with metal implants during an MRI scan with contrast.

2. A client with heart failure is prescribed a low-sodium diet. The nurse notices the client's meal tray contains high-sodium foods. What action should the nurse take?

• A. Educate the client about the importance of a low-sodium diet
• B. Replace the meal with a low-sodium option
• C. Report the error to the dietary department
• D. Encourage the client to avoid eating the high-sodium foods

Correct answer: B

Rationale: The correct action for the nurse to take in this situation is to replace the high-sodium meal with a low-sodium option. This immediate intervention ensures that the client adheres to the prescribed low-sodium diet, crucial for managing heart failure and preventing fluid retention. Educating the client (Choice A) about the diet is important but not as urgent as ensuring they receive the correct meal. Reporting the error to the dietary department (Choice C) can be done after addressing the immediate issue. Encouraging the client to avoid high-sodium foods (Choice D) is not as effective as replacing the current meal with a suitable alternative.

3. The nurse is caring for a client who has just undergone a total hip replacement. Which intervention is most important to prevent postoperative complications?

• A. Encourage early ambulation
• B. Apply ice to the surgical site
• C. Monitor the surgical site for signs of infection
• D. Administer pain medication as prescribed

Correct answer: A

Rationale: Encouraging early ambulation is crucial following a total hip replacement surgery as it helps prevent complications such as deep vein thrombosis (DVT) by promoting circulation. Early ambulation also aids in preventing pneumonia, muscle atrophy, and pressure ulcers. Applying ice to the surgical site may help with pain and swelling, but it is not as critical in preventing complications as early ambulation. While monitoring the surgical site for signs of infection is important, it is not as crucial in preventing postoperative complications compared to early ambulation. Administering pain medication as prescribed is essential for comfort and pain management but does not directly prevent postoperative complications like early ambulation does.

4. The nurse observes that a post-operative client's surgical wound has reddened edges and is oozing. What is the appropriate nursing action?

• A. Apply an antibiotic ointment
• B. Clean the wound with sterile saline
• C. Cover the wound with a sterile dressing
• D. Notify the surgeon immediately

Correct answer: D

Rationale: The correct action when a post-operative client's surgical wound has reddened edges and is oozing is to notify the surgeon immediately. Reddened, oozing wound edges can indicate an infection that requires prompt evaluation and intervention by the surgical team. Applying an antibiotic ointment (Choice A) without proper assessment and guidance can be inappropriate. Cleaning the wound with sterile saline (Choice B) and covering it with a sterile dressing (Choice C) may not address the potential infection adequately, and the client may require more specialized care that the surgeon can provide.

5. A client with a history of chronic kidney disease (CKD) is being discharged with a prescription for epoetin alfa (Epogen). What should the nurse include in the discharge teaching?

• A. Take this medication on an empty stomach.
• B. Monitor your blood pressure regularly.
• C. Expect to feel better immediately.
• D. Avoid foods high in potassium.

Correct answer: B

Rationale: The correct answer is B: 'Monitor your blood pressure regularly.' Epoetin alfa (Epogen) can lead to hypertension as a side effect, so it is essential for clients with CKD to monitor their blood pressure regularly. Choice A is incorrect because epoetin alfa does not need to be taken on an empty stomach. Choice C is incorrect because the client should not expect immediate improvement upon starting the medication. Choice D is incorrect because while monitoring potassium intake is important in CKD, the question specifically pertains to epoetin alfa and its side effects, not potassium intake.

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