Nursing Elites

1. A client presents to the clinic with a large abscess on the right thigh. The healthcare provider incises and drains the abscess. Which instruction should the nurse provide to the client upon discharge?

• A. Avoid showering until the wound is completely closed
• B. Perform daily wound care and dressing changes
• C. Apply heat to the wound for 15 minutes twice a day
• D. Take the prescribed antibiotic until the wound is fully healed

Correct answer: B

Rationale: After incision and drainage of an abscess, it is crucial to perform daily wound care and dressing changes to prevent infection and promote healing. Avoiding showering until the wound is completely closed (choice A) may not be practical or necessary. Applying heat to the wound (choice C) can increase the risk of infection and delay healing. While taking the prescribed antibiotic (choice D) is important, wound care and dressing changes are more directly related to promoting healing and preventing complications.

2. A client receiving IV heparin reports tarry stools and abdominal pain. What interventions should the nurse implement?

• A. Prepare to administer warfarin.
• B. Assess the characteristics of the client's pain.
• C. Obtain recent partial thromboplastin time results.
• D. Monitor stool for the presence of blood.

Correct answer: D

Rationale: The correct intervention for the client receiving IV heparin who reports tarry stools and abdominal pain is to monitor the stool for the presence of blood. This is crucial to assess for gastrointestinal bleeding, a potential complication of heparin therapy. Assessing the characteristics of the client's pain may be helpful but is not the priority when signs of GI bleeding are present. Administering warfarin is not appropriate without a thorough assessment and confirmation of the cause of symptoms. While obtaining recent partial thromboplastin time results is important in monitoring heparin therapy, in this scenario, the immediate concern is to assess for possible GI bleeding.

3. An older adult client with chronic emphysema is admitted to the emergency room with acute weakness, palpitations, and vomiting. Which information is most important for the nurse to obtain during the initial interview?

• A. Recent compliance with prescribed medications.
• B. Sleep patterns during the previous few weeks.
• C. History of smoking over the past 6 months.
• D. Activity level prior to the onset of symptoms.

Correct answer: A

Rationale: The correct answer is A: Recent compliance with prescribed medications. In a client with chronic emphysema experiencing acute symptoms, it is crucial to assess medication compliance as it directly impacts the management of the condition and could contribute to the current presentation. Ensuring that the client has been taking their prescribed medications can provide vital information to guide further treatment. Choices B, C, and D, although important in a comprehensive assessment, are not as immediately crucial as assessing medication compliance in this emergency situation.

4. A client with diabetes mellitus is experiencing hyperglycemia. What laboratory value should the nurse monitor to evaluate long-term glucose control?

• A. Blood glucose level
• B. Glycosylated hemoglobin (A1C)
• C. Urine output
• D. Serum ketone level

Correct answer: B

Rationale: The correct answer is B: Glycosylated hemoglobin (A1C). Glycosylated hemoglobin reflects long-term glucose control over the past three months. Monitoring blood glucose levels provides information on the current glucose status and immediate control, but it does not give a comprehensive view of long-term control. Urine output and serum ketone levels are important indicators for other aspects of diabetes management, such as hydration status and ketone production during hyperglycemic episodes, but they do not directly reflect long-term glucose control.

5. Where should the healthcare provider consider starting a screening program for hypothyroidism?

• A. A business and professional women’s group.
• B. An African-American senior citizens' center.
• C. A daycare center in a Hispanic neighborhood.
• D. An after-school center for Native American teens.

Correct answer: B

Rationale: An African-American senior citizens' center is the most appropriate location to start a screening program for hypothyroidism. Older adults are at an increased risk of hypothyroidism, and African-Americans are more likely to be underserved in healthcare. Therefore, targeting this group can help in early detection and management of hypothyroidism. The other options, such as a business and professional women’s group, a daycare center in a Hispanic neighborhood, and an after-school center for Native American teens, do not align as closely with the demographic at higher risk for hypothyroidism.

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