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 client with a history of urinary tract infections (UTIs) is being cared for by a nurse. Which of the following instructions should the nurse provide to prevent future infections?

• A. Wipe from front to back after urination
• B. Drink 2-3 liters of water per day
• C. Avoid holding urine for long periods
• D. Wear loose-fitting underwear

Correct answer: B

Rationale: The correct answer is to advise the client to drink 2-3 liters of water per day. Adequate hydration helps flush bacteria from the urinary tract, reducing the risk of UTIs. Choice A is incorrect because wiping from front to back is the appropriate technique to prevent the spread of bacteria from the rectal area to the urethra. Choice C is incorrect as holding urine for long periods can contribute to UTIs by allowing bacteria to grow in the bladder. Choice D is incorrect as wearing loose-fitting underwear is recommended to allow air circulation and prevent moisture buildup, reducing the risk of UTIs.

3. A client who is 2 hours postpartum reports heavy bleeding and passing large clots. What is the nurse's priority action?

• A. Perform fundal massage
• B. Administer oxytocin IV
• C. Check vital signs
• D. Encourage the client to void

Correct answer: A

Rationale: The correct answer is A: Perform fundal massage. Fundal massage promotes uterine contractions, which is the initial action to reduce postpartum hemorrhage caused by uterine atony. Checking vital signs (choice C) is important but not the priority when active bleeding is present. Administering oxytocin IV (choice B) may be needed but is not the priority action. Encouraging the client to void (choice D) does not address the underlying issue of postpartum hemorrhage and should not be the priority.

4. A nurse is assessing a newborn 1 hour after birth. The newborn has acrocyanosis and a heart rate of 130 beats per minute. Which of the following actions should the nurse take?

• A. Place the newborn under a radiant warmer
• B. Apply oxygen
• C. Swaddle the newborn
• D. Reassess the newborn in 1 hour

Correct answer: D

Rationale: Acrocyanosis, a bluish discoloration of the hands and feet, is a normal finding in newborns within the first few hours after birth. The heart rate of 130 beats per minute is also within the normal range for a newborn. These findings are typical and do not require immediate intervention. The appropriate action for the nurse is to continue monitoring the newborn. Reassessing the newborn in 1 hour allows the nurse to observe any changes and ensure the newborn's condition remains stable. Placing the newborn under a radiant warmer or applying oxygen is not necessary as the newborn's condition is within normal limits. Swaddling the newborn may provide comfort but is not the priority action in this scenario.

5. A client has been prescribed vasopressin for the treatment of diabetes insipidus. What is the expected pharmacological action of this medication?

• A. To stimulate the pancreas to secrete insulin
• B. To slow the absorption of glucose in the intestine
• C. To increase reabsorption of water in the renal tubules
• D. To increase blood pressure

Correct answer: C

Rationale: The correct answer is C: To increase reabsorption of water in the renal tubules. Vasopressin mimics the action of antidiuretic hormone (ADH) by increasing the reabsorption of water in the renal tubules. This leads to decreased urine output, helping to manage symptoms of diabetes insipidus, which is characterized by excessive thirst and urination. Choices A, B, and D are incorrect. Vasopressin does not stimulate the pancreas to secrete insulin, slow the absorption of glucose in the intestine, or directly increase blood pressure.

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