Nursing Elites

1. A patient scheduled for cataract surgery asks the nurse why they developed cataracts and how to prevent it in the future. What is the nurse's best response?

• A. Age is the biggest factor contributing to cataracts.
• B. Unprotected exposure to UV lights can cause cataracts.
• C. Age, eye injury, corticosteroids, and unprotected sunlight exposure are contributing factors to cataracts.
• D. Unfortunately, there is really nothing you can do to prevent cataracts, but they are amongst the most easily treated eye conditions.

Correct answer: C

Rationale: The correct answer is C: 'Age, eye injury, corticosteroids, and unprotected sunlight exposure are contributing factors to cataracts.' This response is the best choice as it covers the most common contributing factors for cataracts and includes preventable risk factors. Choice A is incorrect because while age is a significant factor in cataract development, it is not the only one. Choice B is incorrect as UV light exposure is a risk factor for cataracts but not the most comprehensive response. Choice D is incorrect as there are preventive measures individuals can take to reduce their risk of developing cataracts, such as protecting their eyes from UV light and managing other risk factors.

2. A couple asks the nurse about risks of several birth control methods. What is the most appropriate response by the nurse?

• A. Norplant is safe and can be easily removed.
• B. Oral contraceptives should not be used by smokers.
• C. Depo-Provera is convenient with few side effects.
• D. The IUD provides protection against pregnancy and infection.

Correct answer: B

Rationale: The correct answer is that oral contraceptives should not be used by smokers. The use of oral contraceptives in a woman who smokes increases the risk of cardiovascular problems, such as thromboembolic disorders. This is due to the combined effect of smoking and hormonal contraceptives. Choices A, C, and D are incorrect because they do not address the specific risk associated with smoking and oral contraceptives. Norplant's safety and ease of removal, Depo-Provera's convenience with few side effects, and the IUD's protection against pregnancy and infection are important points but not directly related to the increased risks for smokers using oral contraceptives.

3. When supporting the psychosocial needs of a client experiencing negative side effects associated with chemotherapy, which intervention is most appropriate?

• A. Read the client's discharge instructions well in advance of dismissal
• B. Provide medications to reduce nausea and vomiting
• C. Give simple instructions about self-care while in the hospital
• D. Determine the levels of support from significant others

Correct answer: D

Rationale: When a client is experiencing negative side effects associated with chemotherapy, addressing their psychosocial needs is crucial. One effective intervention is to determine the levels of support from significant others. This involves assessing the family, spouse, or friends who can provide help and support to the client when healthcare providers are not present. By identifying and organizing these resources, the nurse can help alleviate fears about the future, prepare caregivers for the client's needs, and facilitate a smoother transition for the client upon discharge. Reading discharge instructions, providing medications, or giving self-care instructions, although important, do not directly address the psychosocial needs of the client during this challenging time.

4. When analyzing the results of the urinalysis collected preoperatively from a child with epispadias scheduled for surgical repair, which finding should the nurse most likely expect to note?

• A. Hematuria
• B. Proteinuria
• C. Bacteriuria
• D. Glucosuria

Correct answer: C

Rationale: Epispadias is a congenital defect characterized by the abnormal placement of the urethral orifice of the penis, often on the dorsum. This anatomical anomaly predisposes individuals to bacterial entry into the urinary tract, leading to bacteriuria. Hematuria, proteinuria, and glucosuria are not typically associated with epispadias. Hematuria refers to the presence of blood in the urine, proteinuria indicates protein in the urine, and glucosuria is the presence of glucose in the urine, none of which are commonly seen in epispadias.

5. A man has been taking lisinopril for CHF. The patient is seen in the emergency room for persistent diarrhea. The nurse is concerned about which side effect of lisinopril?

• A. Vertigo
• B. Hypotension
• C. Palpitations
• D. Nagging, dry cough

Correct answer: B

Rationale: The correct answer is 'Hypotension.' Lisinopril, an ACE inhibitor commonly used for CHF, can cause hypotension as a side effect. Persistent diarrhea can lead to dehydration, increasing the risk of hypotension in this patient. Vertigo (choice A) is not a typical side effect of lisinopril. Palpitations (choice C) are not directly associated with lisinopril use. A nagging, dry cough (choice D) is a common side effect of ACE inhibitors like lisinopril, but in this case, the patient's presentation with persistent diarrhea would make hypotension a more immediate concern.

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