Nursing Elites

1. A patient is scheduled for cataract surgery but decides to cancel, stating 'I see just fine.' Which of the following responses should the nurse make?

• A. That’s not a good idea; the surgery is necessary
• B. Share with me more about the thoughts that are concerning you
• C. You should trust your doctor’s advice
• D. You can always reschedule the surgery later

Correct answer: B

Rationale: The correct response is to encourage the patient to share more about their concerns. This approach helps the nurse understand the patient's perspective and allows for a supportive discussion. Choice A is dismissive and does not address the patient's feelings. Choice C may undermine the patient's autonomy and decision-making. Choice D suggests delaying without addressing the patient's current decision.

2. Using Naegele's Rule, what is the estimated delivery date for a pregnant client whose last menstrual period was on May 4th, 2013?

• A. January 15, 2014
• B. February 11, 2014
• C. March 3, 2014
• D. December 25, 2013

Correct answer: B

Rationale: Naegele's rule is a standard method for calculating the estimated delivery date (EDD). It involves subtracting three months from the first day of the last menstrual period (LMP), adding seven days, and then adding one year. For a client with an LMP of May 4th, 2013, subtracting three months gives February 4th. Adding seven days results in a due date of February 11th, 2014, which is the correct answer. Choice A (January 15, 2014) is incorrect as it does not account for the full calculation. Choice C (March 3, 2014) is incorrect as it adds too many days in the calculation. Choice D (December 25, 2013) is incorrect as it does not follow the correct steps of Naegele's rule.

3. A nurse is supervising an LPN who is providing care to a patient who is postoperative. Which of the following statements by the patient requires the nurse to follow up with the LPN?

• A. “I am experiencing some pain, but it’s tolerable.”
• B. “The nurse checked my vital signs earlier.”
• C. “I have not received any of my medications today.”
• D. “I am scheduled for therapy later today.”

Correct answer: C

Rationale: If the patient states they have not received any medications, it requires immediate follow-up to prevent missed doses and complications. The other options do not pose an immediate risk to the patient. Option A indicates pain but is tolerable, which is a common postoperative experience. Option B states that vital signs were checked, indicating ongoing monitoring. Option D mentions therapy, which is a scheduled activity and not an urgent concern regarding medication administration.

4. A client is being educated by a nurse on nutritional intake. Which of the following should the nurse include in the teaching?

• A. Carbohydrates should be at least 45% of your caloric intake
• B. Protein should be at least 55% of your caloric intake
• C. Carbohydrates should be at least 30% of your caloric intake
• D. Protein should be at least 60% of your caloric intake

Correct answer: A

Rationale: Carbohydrates should make up 45-65% of daily caloric intake as they are the body’s main source of energy. This aligns with general dietary recommendations. Choice B is incorrect as protein should typically make up about 10-35% of daily caloric intake, not 55%. Choice C is also incorrect, as carbohydrates should ideally be between 45-65%, not 30%. Choice D is incorrect because protein should generally account for around 10-35% of total caloric intake, not 60%.

5. A nurse in an urgent-care clinic is collecting admission history from a client who is 16 weeks gestation and has bacterial vaginosis. The nurse should recognize that which of the following clinical findings are associated with this infection?

• A. Frequency and dysuria
• B. Profuse milky white discharge
• C. Hematuria
• D. Low-grade fever

Correct answer: B

Rationale: Bacterial vaginosis often presents with a profuse, milky white discharge and a characteristic fishy odor, without significant inflammation, hematuria, or fever. Choice A, frequency, and dysuria are more indicative of a urinary tract infection. Choice C, hematuria, is associated with conditions like urinary tract infections or kidney problems. Choice D, low-grade fever, is not a typical symptom of bacterial vaginosis.

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