Nursing Elites

1. A client with cancer is about to receive low-dose brachytherapy via a vaginal implant. What intervention should be included in the care plan?

• A. Remove vaginal packing.
• B. Insert an indwelling urinary catheter.
• C. Ambulate the client four times daily.
• D. Keep the client NPO until therapy is complete.

Correct answer: B

Rationale: The correct intervention that should be included in the care plan for a client about to receive low-dose brachytherapy via a vaginal implant is to insert an indwelling urinary catheter. This is crucial to prevent bladder distention during brachytherapy, ensuring the treatment's effectiveness and the client's comfort. Removing vaginal packing (Choice A) may not be necessary or appropriate in this situation. Ambulating the client four times daily (Choice C) is a good nursing intervention for general patient care but is not specifically related to brachytherapy via a vaginal implant. Keeping the client NPO until therapy is complete (Choice D) is not necessary unless specifically indicated due to the treatment's nature or the client's condition.

2. A client who is at 28 weeks of gestation is being taught by a nurse about managing heartburn. Which of the following instructions should the nurse include?

• A. Eat small, frequent meals.
• B. Drink a glass of milk with each meal.
• C. Lie down after meals.
• D. Drink plenty of fluids with meals.

Correct answer: A

Rationale: The correct instruction for managing heartburn during pregnancy is to eat small, frequent meals. This helps prevent heartburn by reducing gastric distention. Option B, drinking a glass of milk with each meal, may exacerbate heartburn in some individuals due to its fat content. Option C, lying down after meals, can worsen heartburn as it allows stomach acid to flow back into the esophagus. Option D, drinking plenty of fluids with meals, can also contribute to heartburn by distending the stomach. Therefore, the best advice for managing heartburn during pregnancy is to eat small, frequent meals.

3. A client with gastroesophageal reflux disease (GERD) is being taught about lifestyle modifications. Which of the following instructions should be included?

• A. Sleep with the head of the bed elevated.
• B. Avoid drinking fluids with meals.
• C. Eat three large meals each day.
• D. Lie down after eating.

Correct answer: B

Rationale: The correct instruction for a client with GERD is to avoid drinking fluids with meals. This is because consuming fluids while eating can exacerbate reflux symptoms by increasing stomach distension and contributing to the reflux of stomach contents into the esophagus. Option A is incorrect as elevating the head of the bed can help prevent reflux during sleep, not while drinking fluids. Option C is incorrect as consuming three large meals a day can worsen GERD symptoms due to increased gastric distension. Option D is incorrect as lying down after eating can also worsen GERD symptoms by promoting the reflux of stomach contents into the esophagus.

4. A healthcare provider is assessing a client who has acute pancreatitis. Which of the following laboratory results should the healthcare provider expect to be elevated?

• A. Serum sodium.
• B. Serum calcium.
• C. Serum glucose.
• D. Serum amylase.

Correct answer: D

Rationale: Serum amylase levels are typically elevated in clients with acute pancreatitis as it is an enzyme released by the pancreas. Elevated serum sodium, calcium, or glucose levels are not typically associated with acute pancreatitis. Therefore, choices A, B, and C are incorrect.

5. What is the appropriate action for a patient experiencing chest pain?

• A. Administer aspirin
• B. Reposition the patient
• C. Check oxygen saturation
• D. Prepare for surgery

Correct answer: A

Rationale: The correct action for a patient experiencing chest pain is to administer aspirin. Aspirin helps reduce the risk of clot formation in patients with chest pain, as it has antiplatelet effects. Repositioning the patient may not address the underlying cause of the chest pain. Checking oxygen saturation is important but not the initial priority in this scenario. Surgery is not typically the first-line treatment for chest pain without further assessment and diagnostic procedures.

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