Nursing Elites

1. A client returning from the surgical suite following a vaginal hysterectomy is awake and asking for something to drink. Her post-op diet prescription reads: 'clear liquids, advance diet as tolerated.' Which of the following is appropriate for the nurse to tell the patient?

• A. ''I am going to listen to your abdomen.''
• B. ''You need to wait until the surgeon evaluates your condition.''
• C. ''You can have clear liquids, but let me check with the surgeon first.''
• D. ''It is best to start with small sips of clear liquids and observe how you feel.''

Correct answer: A

Rationale: The correct answer is A: ''I am going to listen to your abdomen.'' Listening to the abdomen helps assess bowel sounds and ensure that the client’s gastrointestinal system is ready for oral intake. Choice B is incorrect because the client does not necessarily need to wait for the surgeon to evaluate before starting with clear liquids. Choice C is incorrect because unless there are specific contraindications, clear liquids are usually allowed after surgery. Choice D is incorrect as it does not address the immediate assessment needed before initiating oral intake post-operatively.

2. When should discharge planning for a patient admitted to the neurological unit with a diagnosis of stroke begin?

• A. At the time of admission
• B. The day before the patient is to be discharged
• C. When outpatient therapy is no longer needed
• D. As soon as the patient's discharge destination is known

Correct answer: A

Rationale: Discharge planning for a patient admitted to the neurological unit with a stroke diagnosis should begin at the time of admission. Initiating discharge planning early allows for a comprehensive assessment of the patient's needs, enables better coordination of care, and ensures a smooth transition from the hospital to the next level of care. Option B is incorrect because waiting until the day before discharge does not provide enough time for adequate planning. Option C is incorrect because waiting until outpatient therapy is no longer needed delays the planning process. Option D is incorrect because waiting until the discharge destination is known may result in rushed planning and inadequate preparation for the patient's needs.

3. When assessing a male client, the nurse finds that he is fatigued and is experiencing muscle weakness, leg cramps, and cardiac dysrhythmias. Based on these findings, the nurse plans to check the client's laboratory values to validate the existence of which condition?

• A. Hyperphosphatemia
• B. Hypocalcemia
• C. Hypermagnesemia
• D. Hypokalemia

Correct answer: D

Rationale: The symptoms of muscle weakness, leg cramps, and cardiac dysrhythmias are indicative of hypokalemia, a condition characterized by low potassium levels. Checking the client's laboratory values for potassium will help confirm this diagnosis. Hyperphosphatemia (Choice A) is an elevated phosphate level in the blood, which is not consistent with the symptoms described. Hypocalcemia (Choice B) is a low calcium level and typically presents with different symptoms than those mentioned in the scenario. Hypermagnesemia (Choice C) is an excess of magnesium in the blood and does not align with the symptoms of muscle weakness, leg cramps, and cardiac dysrhythmias observed in the client.

4. A patient's neighbor is scheduled for elective surgery. The neighbor’s provider indicated that a moderate amount of blood loss is expected during the surgery, and the neighbor is anxious about acquiring an infection from a blood transfusion. Which of the following is appropriate for the nurse to suggest?

• A. Avoid the blood transfusion
• B. Donate autologous blood before the surgery
• C. Use a blood substitute
• D. Take antibiotics before the surgery

Correct answer: B

Rationale: Donating autologous blood before surgery is an appropriate suggestion by the nurse. This process involves the patient donating their own blood before the surgery, which reduces the risk of infection from transfusions as the patient is receiving their own blood. Choice A is incorrect as avoiding the blood transfusion may not be feasible or safe in the context of expected blood loss during surgery. Choice C is not a common practice and may carry its own risks. Choice D is not directly related to reducing the risk of infection from a blood transfusion.

5. A nurse on a medical-surgical unit is admitting a client. Which of the following information should the nurse document in the client's record first?

• A. Assessment
• B. Plan of care
• C. Client history
• D. Medication list

Correct answer: A

Rationale: The correct answer is A: Assessment. When admitting a client, the nurse should document assessment data first. This information is crucial as it provides a baseline for planning care and treatment. By documenting the assessment initially, the nurse can accurately identify the client's needs and prioritize care. Choice B, Plan of care, would be developed based on the assessment findings, so it should come after the initial assessment. Choices C and D, Client history and Medication list, are important but would typically be documented after the assessment to ensure that the most current and relevant information is captured in the client's record.

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