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 nurse is assessing a client who is in active labor and notes the FHR baseline has been 100/min for the past 15 minutes. The nurse should identify which of the following conditions as a possible cause of fetal bradycardia?

• A. Maternal fever.
• B. Fetal anemia.
• C. Maternal hypoglycemia.
• D. Chorioamnionitis.

Correct answer: C

Rationale: In this scenario, the fetal heart rate (FHR) baseline of 100/min for the past 15 minutes indicates bradycardia. Maternal hypoglycemia can lead to decreased oxygen supply to the fetus, resulting in fetal bradycardia. This situation requires immediate intervention to address the underlying cause. Choices A, B, and D are incorrect as they are not typically associated with fetal bradycardia. Maternal fever, fetal anemia, and chorioamnionitis may have other effects on the fetus but are not primary causes of bradycardia in this context.

3. A nurse is providing teaching to a client who has a new prescription for warfarin. Which of the following statements indicates a need for further teaching?

• A. I will take warfarin every other day.
• B. I will eat more leafy green vegetables while taking warfarin.
• C. I will use a soft toothbrush while taking warfarin.
• D. I will have my INR checked regularly while taking warfarin.

Correct answer: B

Rationale: The correct answer is B. Eating more leafy green vegetables can increase vitamin K intake, which may reduce the effectiveness of warfarin. This can lead to fluctuations in the International Normalized Ratio (INR) levels, affecting the medication's efficacy. Choices A, C, and D are correct statements. Taking warfarin every other day, using a soft toothbrush to prevent gum bleeding, and having regular INR checks are all appropriate and important actions when taking warfarin.

4. A healthcare professional is reviewing the laboratory results of a client who has chronic kidney disease. Which of the following findings should the healthcare professional report to the provider?

• A. Serum potassium 4.5 mEq/L
• B. Serum calcium 9.2 mg/dL
• C. Serum creatinine 2.5 mg/dL
• D. Serum albumin 3.5 g/dL

Correct answer: C

Rationale: Elevated serum creatinine levels indicate impaired kidney function. As kidney disease progresses, the kidneys are less able to filter waste products, leading to an increase in creatinine levels. Therefore, a high serum creatinine level of 2.5 mg/dL should be reported to the provider for further evaluation and management. Choices A, B, and D are within normal ranges and do not directly signify worsening kidney function in this context.

5. A nurse is teaching a prenatal class about infection. Which statement by the client indicates further teaching is required?

• A. I can visit someone with chickenpox 5 days after the sores crust.
• B. I should avoid eating foods that contain high folic acid.
• C. I can clean my cat's litter box during pregnancy.
• D. I should wash my hands with hot water for 10 seconds after gardening.

Correct answer: C

Rationale: The correct answer is C because cleaning a cat's litter box during pregnancy can increase the risk of toxoplasmosis, which can be harmful to the developing fetus. Choice A is correct as the statement indicates understanding of the chickenpox transmission timeline. Choice B is also correct as high folic acid foods are beneficial during pregnancy. Choice D is correct as washing hands with hot water after gardening helps prevent infections.

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