Nursing Elites

1. A male patient who had surgery 2 days ago for head and neck cancer is about to make his first attempt to ambulate outside his room. The nurse notes that he is steady on his feet and that his vision was unaffected by the surgery. Which of the following nursing interventions would be appropriate?

• A. Encourage the patient to walk in the hall alone
• B. Discourage the patient from walking in the hall for a few more days
• C. Accompany the patient for his walk
• D. Consult a physical therapist before allowing the patient to ambulate

Correct answer: C

Rationale: Accompanying the patient for his walk is the appropriate nursing intervention in this scenario to ensure his safety during his first ambulation. This allows the nurse to provide immediate assistance if needed and ensures the patient's well-being during this critical postoperative period.

2. What is the best description of Back Care?

• A. Caring for the back by means of massage
• B. Washing the back
• C. Applying a cold compress to the back
• D. Applying a hot compress to the back

Correct answer: A

Rationale: The correct answer is A: Caring for the back by means of massage. Back Care involves activities like massage, exercises, maintaining proper posture, and using ergonomic practices to keep the spine healthy and prevent injuries. While washing the back is a hygiene practice, applying cold or hot compresses may provide relief for back pain but do not encompass the comprehensive approach of back care like massage does.

3. A healthcare professional is preparing to administer a dose of a new prescription of prednisone to a client who has COPD. The healthcare professional should not concentrate on which of the following adverse effects of this medication?

• A. Hypokalemia
• B. Tachycardia
• C. Fluid retention
• D. Black, tarry stools

Correct answer: B

Rationale: When administering prednisone, a corticosteroid medication, to a client with COPD, the healthcare professional should be aware of potential adverse effects. Tachycardia is not a common adverse effect of prednisone use. The correct adverse effects to monitor for include hypokalemia, fluid retention, and gastrointestinal issues like black, tarry stools due to potential gastrointestinal bleeding. Therefore, the healthcare professional should not concentrate on tachycardia but should focus on the other listed adverse effects when administering prednisone to a client with COPD.

4. A client is experiencing preterm contractions and dehydration. Which of the following statements should the nurse make?

• A. Dehydration is treated with calcium supplements.
• B. Dehydration can increase the risk of preterm labor.
• C. Dehydration is associated with gastroesophageal reflux.
• D. Dehydration is caused by decreased hemoglobin and hematocrit.

Correct answer: B

Rationale: Dehydration can lead to an imbalance in electrolytes and cause uterine irritability, potentially leading to preterm contractions. It is essential for the nurse to educate the client on the importance of adequate hydration to reduce the risk of preterm labor. The statement 'Dehydration can increase the risk of preterm labor' directly addresses the client's condition and provides relevant information for their understanding and management of the situation.

5. Which of the following procedures always requires surgical asepsis?

• A. Vaginal instillation of conjugated estrogen
• B. Urinary catheterization
• C. Nasogastric tube insertion
• D. Colostomy irrigation

Correct answer: B

Rationale: Surgical asepsis, which involves maintaining a sterile field and preventing contamination in a surgical setting, is required for urinary catheterization as it involves entering a sterile body cavity. Vaginal instillation of conjugated estrogen, nasogastric tube insertion, and colostomy irrigation do not always require surgical asepsis as they involve different levels of sterility and infection control measures.

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