Nursing Elites

1. When assessing a client with a small bowel obstruction, what finding should a nurse expect?

• A. Significant abdominal distention
• B. Large bowel movements
• C. High-pitched bowel sounds
• D. Copious vomiting

Correct answer: C

Rationale: High-pitched bowel sounds are often heard early in a small bowel obstruction due to increased peristalsis as the bowel tries to overcome the blockage. Choices A, B, and D are incorrect. Abdominal distention is more commonly associated with large bowel obstructions, while large bowel movements and copious vomiting are not typical findings in small bowel obstructions.

2. A nurse is teaching a group of clients about measures to prevent the development of skin cancer. Which of the following client statements indicates a need for further teaching?

• A. I will avoid going outside between 1000 and 1600.
• B. I will wear a wide-brimmed hat when I go outside.
• C. I will make sure to apply sunscreen with SPF 10 when I’m in the sun.
• D. I will reapply my sunscreen every 2 hours.

Correct answer: C

Rationale: The correct answer is C. An SPF of at least 15 is recommended to effectively protect against harmful UV rays. A sunscreen with an SPF of 10 is insufficient and does not provide adequate protection against skin cancer. Choices A, B, and D demonstrate good understanding of sun protection measures, such as avoiding peak sun hours, wearing protective clothing like a wide-brimmed hat, and reapplying sunscreen every 2 hours, which are all effective strategies to prevent skin cancer.

3. A nurse is preparing to administer a dose of digoxin. Which of the following should the nurse do first?

• A. Assess blood pressure
• B. Check heart rate
• C. Monitor potassium levels
• D. Review the medication order

Correct answer: B

Rationale: The correct answer is to check the heart rate first before administering digoxin. Digoxin is a medication that directly affects the heart, so it is crucial to ensure that the heart rate is within the appropriate range before giving the dose. If the heart rate is below 60 bpm, administering digoxin could lead to toxicity. Assessing blood pressure (Choice A) is important but not the first priority when preparing to administer digoxin. Monitoring potassium levels (Choice C) is also crucial for patients on digoxin, but it is not the initial step. Reviewing the medication order (Choice D) is necessary but can be done after checking the heart rate.

4. A nurse is reviewing dietary assessment findings for a client who is Jewish and observes kosher dietary practices. Which of the following behaviors should the nurse expect to find?

• A. Leavened bread may be eaten during Passover
• B. Shellfish is commonly consumed in the diet
• C. Meat and dairy products are eaten separately
• D. Fasting from meat occurs during Hanukkah

Correct answer: C

Rationale: The correct answer is C. According to kosher dietary laws, meat and dairy products cannot be consumed together. This practice stems from the prohibition in Jewish law against cooking a young animal in its mother's milk. Therefore, the nurse should expect to find that meat and dairy products are eaten separately. Choices A, B, and D are incorrect. Leavened bread is not eaten during Passover (Choice A), shellfish is not consumed in the kosher diet (Choice B), and fasting from meat does not occur during Hanukkah (Choice D).

5. A charge nurse is preparing an educational session about addictive disorders for nursing staff. Which of the following should the nurse include as an etiological factor of addictive disorder?

• A. Low self-esteem
• B. Family history of addiction
• C. Personality disorders
• D. All of the above

Correct answer: D

Rationale: The correct answer is D: All of the above. Addiction is influenced by various factors, including low self-esteem, family history of addiction, and specific personality traits. Low self-esteem can lead individuals to seek solace in substances, a family history of addiction can increase the likelihood of developing addictive behaviors due to genetic and environmental factors, and certain personality disorders may contribute to addictive tendencies. Therefore, all the factors listed in choices A, B, and C can play a role in the development of addictive disorders. Choices A, B, and C are incorrect because addictive disorders are multifactorial, and it is essential to consider a combination of influences rather than isolating a single factor.

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