Nursing Elites

1. A client has a prescription for a 24-hour urine collection. Which of the following actions should be taken by the healthcare provider?

• A. Discard the first voiding.
• B. Keep the urine at room temperature.
• C. Collect the first voiding.
• D. Keep the urine in a sterile container.

Correct answer: A

Rationale: Discarding the first voiding is necessary when initiating a 24-hour urine collection to ensure that the collection starts with an empty bladder. This step helps in obtaining an accurate measurement of substances excreted over the 24-hour period without any carryover from the previous voids. Keeping the urine at room temperature or in a sterile container is not specific to the initiation of the collection. Therefore, the correct action is to discard the first voiding. Choice B is incorrect because keeping urine at room temperature is important for some tests, but it is not specific to the initiation of a 24-hour urine collection. Choice C is incorrect because collecting the first voiding would lead to inaccurate results as the bladder is not empty at the start. Choice D is incorrect because while keeping urine in a sterile container is generally a good practice, it is not a specific step for initiating a 24-hour urine collection.

2. During postoperative teaching following a hip arthroplasty, which instruction should the nurse include?

• A. Avoid lying on your operative side.
• B. Cross your legs at the ankles only.
• C. Place a pillow between your legs when turning.
• D. Avoid bending your hip more than 120 degrees.

Correct answer: C

Rationale: The correct instruction for the nurse to include during postoperative teaching following a hip arthroplasty is to 'Place a pillow between your legs when turning.' Placing a pillow between the legs when turning is crucial as it helps prevent dislocation of the hip prosthesis. This position aids in maintaining proper alignment and stability, thereby reducing the risk of complications after hip arthroplasty surgery. Choices A, B, and D are incorrect because they do not directly address the specific action needed to protect the hip prosthesis and prevent complications.

3. When planning care for a client with a pressure ulcer, which intervention should the nurse include in the plan?

• A. Massage the reddened area.
• B. Apply a donut-shaped cushion.
• C. Reposition the client every 3 hours.
• D. Use a transparent film dressing.

Correct answer: D

Rationale: The correct intervention for a client with a pressure ulcer is to use a transparent film dressing. This dressing provides a protective barrier against external contaminants while allowing for wound inspection, promoting healing. Massaging the reddened area can cause further damage to the skin and should be avoided. Donut-shaped cushions can increase pressure on the ulcer site rather than alleviate it. Repositioning the client every 2 hours is a preventive measure for pressure ulcers, but once an ulcer has developed, using a transparent film dressing is a more appropriate intervention to facilitate healing and protect the wound site.

4. When teaching a client with a new diagnosis of heart failure about dietary management, which of the following statements should the nurse include?

• A. Increase your intake of sodium-rich foods.
• B. Decrease your intake of sodium-rich foods.
• C. Avoid foods that contain lactose.
• D. Increase your intake of dairy products.

Correct answer: B

Rationale: The correct answer is to decrease the intake of sodium-rich foods. Sodium restriction is crucial in managing heart failure as it helps to reduce fluid retention and alleviate symptoms. Excessive sodium intake can lead to fluid buildup in the body, worsening heart failure. Therefore, advising the client to decrease sodium-rich foods is essential for their overall health and management of the condition. Choices A, C, and D are incorrect. Increasing intake of sodium-rich foods (Choice A) would worsen fluid retention and heart failure symptoms. Avoiding foods that contain lactose (Choice C) is not directly related to heart failure management through sodium restriction. Increasing intake of dairy products (Choice D) may not be suitable for all heart failure patients, especially if they need to limit saturated fats or cholesterol in their diet.

5. A healthcare provider is assessing a client who has fluid volume excess. Which of the following findings should the healthcare provider expect?

• A. Hypotension
• B. Bradycardia
• C. Crackles in the lungs
• D. Dry mucous membranes

Correct answer: C

Rationale: Crackles in the lungs are indicative of fluid accumulation in the alveoli, which is a characteristic finding in clients with fluid volume excess. The crackling sound occurs due to the presence of excess fluid in the lungs, impairing normal ventilation and gas exchange. Monitoring for crackles is essential for early detection and management of fluid overload in clients. Choices A, B, and D are incorrect because in fluid volume excess, hypervolemia leads to increased blood pressure (not hypotension), compensatory tachycardia (not bradycardia), and moist mucous membranes (not dry).

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