Nursing Elites

1. A nurse is preparing to perform a bladder scan for a client who has overflow incontinence. Which of the following actions should the nurse take?

• A. Place the client in a supine position.
• B. Obtain a prescription for insertion of an indwelling catheter.
• C. Cleanse the client's abdomen with an antiseptic solution.
• D. Prepare the client for urinary catheterization.

Correct answer: D

Rationale: The correct answer is to prepare the client for urinary catheterization. Overflow incontinence may indicate bladder distention, where a bladder scan helps assess the need for catheterization. Placing the client in a supine position (Choice A) is not directly related to the procedure. Obtaining a prescription for an indwelling catheter (Choice B) is not necessary before performing a bladder scan. Cleansing the client's abdomen with an antiseptic solution (Choice C) is not specific to preparing for a bladder scan in this situation.

2. A nurse is teaching a client who has a new prescription for alendronate. Which of the following instructions should the nurse include in the teaching?

• A. Take this medication at bedtime.
• B. Take this medication with food.
• C. Remain upright for at least 30 minutes after taking this medication.
• D. Avoid taking this medication with calcium-rich foods.

Correct answer: C

Rationale: The correct answer is C: 'Remain upright for at least 30 minutes after taking this medication.' This instruction is crucial when taking alendronate as it reduces the risk of esophagitis by preventing the medication from irritating the esophagus. Choice A is incorrect because alendronate should be taken in the morning, not at bedtime, to enhance absorption. Choice B is incorrect as alendronate should be taken on an empty stomach, preferably in the morning, with a full glass of water. Choice D is incorrect as there are no specific restrictions on taking alendronate with calcium-rich foods.

3. A nurse is caring for a client who has a prescription for a high-protein diet. Which of the following foods should the nurse recommend?

• A. Almonds
• B. Cheddar cheese
• C. Chicken breast
• D. Pasta

Correct answer: C

Rationale: Chicken breast is an excellent choice for a high-protein diet as it is a lean source of protein. Almonds, while a good source of protein, also contain high amounts of fat. Cheddar cheese is high in protein but also high in saturated fat. Pasta is not a significant source of protein compared to chicken breast.

4. When documenting an incorrect dose of medication administered, which fact related to the incident report should the nurse document in the client's medical record?

• A. Time the medication was given
• B. The client's response to the medication
• C. The dose that was administered
• D. Reason for the error

Correct answer: A

Rationale: The nurse should document the time the medication was given in the client's medical record when an incorrect dose is administered. Recording the time is crucial for establishing the sequence of events accurately. Choices B, C, and D, though important, are not directly relevant to documenting the incident of administering an incorrect dose of medication. The client's response to the medication, the actual dose administered, and the reason for the error may be documented for overall patient care but are not specifically required in the incident report for an incorrect dose.

5. A nurse is providing teaching to a client who is postoperative following a cataract extraction. Which of the following statements should the nurse include?

• A. You should expect to have eye pain for the first 2 days after surgery.
• B. You should bend at the waist to pick up objects from the floor.
• C. You should avoid sleeping on the side of the body that was operated on.
• D. You should wear an eye shield at night for 2 weeks.

Correct answer: D

Rationale: The correct answer is D. After cataract surgery, wearing an eye shield at night for 2 weeks is essential to protect the eye during the initial healing period. Choice A is incorrect because significant eye pain should not be expected for the first 2 days after surgery. Choice B is incorrect as bending at the waist can increase intraocular pressure, which should be avoided postoperatively. Choice C is incorrect as there is no need to avoid sleeping on the side of the body that was operated on after cataract surgery.

Similar Questions