Nursing Elites

1. A client is experiencing urinary incontinence, and a nurse is providing care. Which of the following recommendations should the nurse include in the teaching plan for this client?

• A. Drink large amounts of water before bedtime
• B. Perform Kegel exercises regularly
• C. Limit fiber intake in the diet to avoid bowel irritation
• D. Increase intake of caffeinated and carbonated beverages

Correct answer: B

Rationale: The correct recommendation for a client experiencing urinary incontinence is to perform Kegel exercises regularly. These exercises help strengthen the pelvic floor muscles, improving bladder control and reducing urinary incontinence. Option A is incorrect because drinking large amounts of water before bedtime can worsen urinary incontinence by increasing urine production. Option C is incorrect as fiber is important for bowel health and limiting it may not be beneficial for the client. Option D is incorrect as caffeinated and carbonated beverages can irritate the bladder and worsen urinary incontinence, so they should be avoided.

2. A nurse is caring for a client who is postpartum, has a deep-vein thrombosis, and is receiving heparin therapy via subcutaneous injections. Which of the following actions should the nurse take?

• A. Request a prescription for PRN aspirin from the provider.
• B. Massage the injection site thoroughly following administration.
• C. Instruct the client that they cannot breastfeed while receiving heparin.
• D. Administer the injection in the client's abdomen.

Correct answer: D

Rationale: The nurse should administer the injection in the abdomen, as this is a common site for subcutaneous heparin administration. Massaging the injection site can lead to bruising or discomfort and should be avoided. Instructing the client not to breastfeed while on heparin is inaccurate, as heparin does not pass into breast milk in significant amounts. Aspirin is contraindicated for clients on heparin due to the increased risk of bleeding, so requesting a prescription for PRN aspirin would not be appropriate in this situation.

3. A healthcare professional is planning a community education program about colorectal cancer. Which of the following risk factors should the professional identify as modifiable?

• A. Family history
• B. Smoking
• C. Age
• D. Gender

Correct answer: B

Rationale: The correct answer is B: Smoking. Smoking is a modifiable risk factor for colorectal cancer. It is within an individual's control to quit smoking, thereby reducing their risk of developing colorectal cancer. Choices A, C, and D are non-modifiable risk factors. Family history, age, and gender are factors that individuals cannot change or control. While family history can influence risk, it is not something that can be modified. Age and gender are also non-modifiable factors when it comes to colorectal cancer risk.

4. A client who has osteoporosis is being discharged with a new prescription for alendronate. Which of the following instructions should the nurse provide?

• A. Take the medication at bedtime.
• B. Take the medication with a full glass of water.
• C. Take the medication with food.
• D. Lie down for 30 minutes after taking the medication.

Correct answer: B

Rationale: The correct answer is to take the medication with a full glass of water. Alendronate should be taken with a full glass of water to prevent esophageal irritation. Additionally, the client should remain upright for 30 minutes after taking it to prevent potential adverse effects. Choice A is incorrect because alendronate should not be taken at bedtime, but rather in the morning on an empty stomach. Choice C is incorrect because alendronate should be taken on an empty stomach, not with food. Choice D is incorrect because the client should remain upright, not lie down, for 30 minutes after taking the medication.

5. A nurse is preparing to administer an enteral tube feeding through an NG tube at 250 mL over 4 hr. The nurse should set the pump to deliver how many mL/hr?

• A. 60 mL/hr
• B. 62 mL/hr
• C. 63 mL/hr
• D. 65 mL/hr

Correct answer: C

Rationale: Calculation: 250 mL / 4 hours = 62.5 mL/hr, which should be rounded up to 63 mL/hr. This ensures the correct rate is set for continuous feeding. Choice A (60 mL/hr) is incorrect as it does not reflect the accurate calculation. Choice B (62 mL/hr) is close but does not round up to the nearest whole number as required. Choice D (65 mL/hr) is higher than the correct calculation and would deliver the feeding solution at a faster rate than prescribed.

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