Nursing Elites

1. A client is scheduled for an arteriogram. The nurse should explain to the client that the arteriogram will confirm the diagnosis of occlusive arterial disease by:

• A. Showing the location of the obstruction and the collateral circulation.
• B. Scanning the affected extremity and identifying the areas of volume changes.
• C. Using ultrasound to estimate the velocity changes in the blood vessels.
• D. Determining how long the client can walk.

Correct answer: A

Rationale: The correct answer is A: Showing the location of the obstruction and the collateral circulation. An arteriogram is a diagnostic procedure that involves injecting a contrast agent to visualize the blood vessels and identify the location of any obstructions. This helps confirm the diagnosis of occlusive arterial disease by showing where the blockage is located and how collateral circulation is compensating for the reduced blood flow. Choices B, C, and D are incorrect because scanning the extremity, estimating velocity changes with ultrasound, or determining walking distance are not the primary purposes of an arteriogram in diagnosing occlusive arterial disease.

2. Which of the following is a priority intervention for a patient with suspected sepsis?

• A. Administering antibiotics.
• B. Administering IV fluids.
• C. Administering antipyretics.
• D. Monitoring blood cultures.

Correct answer: D

Rationale: Monitoring blood cultures is a crucial intervention in suspected sepsis because it helps identify the causative organism, which is essential for guiding appropriate antibiotic therapy. Administering antibiotics (Choice A) is important but should be guided by blood culture results. Administering IV fluids (Choice B) is also essential to support hemodynamic stability in sepsis. Administering antipyretics (Choice C) may help reduce fever but is not a priority compared to identifying the causative organism through blood cultures.

3. A client scheduled for the surgical creation of an ileal conduit expresses anxiety and asks about having a drainage tube. How should the nurse respond?

• A. I will ask the provider to prescribe you an antianxiety medication.
• B. Would you like to discuss the procedure with your doctor once more?
• C. I think it would be nice to not have to worry about finding a bathroom.
• D. Would you like to speak with someone who has an ileal conduit?

Correct answer: D

Rationale: The most appropriate response for the nurse is to offer the client the opportunity to speak with someone who has undergone the same procedure. This allows the client to gain insight, ask questions, and share concerns with someone who has firsthand experience, which can help alleviate anxiety and promote a positive self-image. Seeking an antianxiety medication does not address the client's emotional concerns or promote a positive attitude towards the procedure. Discussing the procedure with the doctor again may provide more information but may not offer the same level of emotional support and understanding as speaking with someone who has lived through the experience. Commenting on the convenience of not having to search for a bathroom minimizes the client's anxiety and overlooks the emotional aspect of the client's concerns.

4. After a transsphenoidal hypophysectomy, the nurse should assess the client for:

• A. Cerebrospinal fluid (CSF) leak.
• B. Fluctuating blood glucose levels.
• C. Cushing's syndrome.
• D. Cardiac arrhythmias.

Correct answer: A

Rationale: Following a transsphenoidal hypophysectomy, assessing the client for a cerebrospinal fluid (CSF) leak is crucial due to the risk of this serious complication. A CSF leak can lead to infection and increased intracranial pressure, which must be promptly identified and managed to prevent further complications. Fluctuating blood glucose levels (Choice B) are not directly associated with a transsphenoidal hypophysectomy. Cushing's syndrome (Choice C) is a condition related to prolonged exposure to high levels of cortisol and is not a common immediate concern post-transsphenoidal hypophysectomy. Cardiac arrhythmias (Choice D) are not typically a direct complication of this surgical procedure, making it a less relevant concern compared to a CSF leak.

5. Which of the following is a characteristic of chronic obstructive pulmonary disease (COPD)?

• A. Increased lung compliance.
• B. Decreased lung elasticity.
• C. Increased respiratory rate.
• D. Increased lung expansion.

Correct answer: B

Rationale: The correct answer is B: Decreased lung elasticity. Chronic obstructive pulmonary disease (COPD) is characterized by a loss of lung elasticity, which leads to difficulty in exhaling air. This decreased elasticity results in air becoming trapped in the lungs, making it challenging for the individual to breathe effectively. Choice A is incorrect as COPD is associated with decreased lung compliance, not increased compliance. Choice C is incorrect as individuals with COPD often have a decreased respiratory rate due to impaired lung function. Choice D is incorrect as COPD causes limited lung expansion due to factors like air trapping and hyperinflation.

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