Nursing Elites

1. A client is 2 hr postoperative following a total hip arthroplasty. Which of the following actions should the nurse take?

• A. Position the client supine with a pillow between the legs.
• B. Place an abduction pillow between the client's legs.
• C. Place a pillow under the client's knees.
• D. Position the client's legs in adduction.

Correct answer: B

Rationale: After a total hip arthroplasty, it is crucial to prevent hip dislocation. Placing an abduction pillow between the client's legs helps maintain proper alignment of the hip joint and prevents adduction, which could lead to dislocation. Therefore, choice B is the correct action. Choice A is incorrect because positioning the client supine with a pillow between the legs does not provide the necessary abduction to prevent dislocation. Choice C, placing a pillow under the client's knees, does not address the need for abduction. Choice D, positioning the client's legs in adduction, is incorrect as adduction increases the risk of hip dislocation following hip arthroplasty.

2. A client is 24 hours postoperative following a right-sided mastectomy. Which of the following interventions should the nurse include in the plan of care?

• A. Place the client in the supine position.
• B. Encourage the client to lift objects with the right arm.
• C. Measure the client's blood pressure on the right arm.
• D. Elevate the client's right arm on a pillow.

Correct answer: D

Rationale: Elevating the client's right arm on a pillow is essential post-mastectomy to reduce swelling and promote circulation. Placing the client in the supine position may not be comfortable or ideal after a mastectomy. Encouraging the client to lift objects with the right arm can strain the surgical site and hinder healing. Measuring the client's blood pressure on the right arm should be avoided to prevent disruption to the area and inaccurate readings.

3. A healthcare provider is caring for a client who has asthma and is experiencing wheezing. Which of the following medications should the healthcare provider administer?

• A. Fluticasone
• B. Montelukast
• C. Albuterol
• D. Ipratropium

Correct answer: C

Rationale: Albuterol is a short-acting beta-agonist bronchodilator used to quickly relieve bronchospasm in clients with asthma who are experiencing wheezing. Fluticasone is an inhaled corticosteroid used for long-term control of asthma symptoms and not for acute wheezing. Montelukast is a leukotriene receptor antagonist used for long-term asthma management, not for immediate relief of wheezing. Ipratropium is an anticholinergic bronchodilator used for chronic obstructive pulmonary disease (COPD) and not typically used as the first-line treatment for asthma exacerbation.

4. A nurse is caring for a client who has acute pancreatitis. Which of the following laboratory results should the nurse expect to be elevated?

• A. Serum creatinine.
• B. Amylase.
• C. Hemoglobin.
• D. Blood glucose.

Correct answer: B

Rationale: The correct answer is B: Amylase. Amylase is typically elevated in clients with acute pancreatitis due to inflammation of the pancreas. Elevated serum creatinine levels are more indicative of kidney dysfunction rather than pancreatitis. Hemoglobin levels are not directly related to pancreatitis. While blood glucose levels can be affected by pancreatitis, they are not typically the primary laboratory result expected to be elevated in this condition.

5. What is the appropriate diet for a patient with chronic kidney disease?

• A. Low protein diet
• B. High protein diet
• C. Low sodium diet
• D. Low potassium diet

Correct answer: A

Rationale: A low protein diet is the appropriate choice for a patient with chronic kidney disease because it helps to reduce the buildup of waste products in the body, which the kidneys may struggle to filter out. High protein diets can put extra strain on the kidneys by increasing the workload to eliminate the byproducts of protein metabolism. While low sodium and low potassium diets can also be important for managing certain aspects of kidney disease, the primary focus should be on controlling protein intake to lessen the burden on the kidneys.

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