Nursing Elites

1. A patient is receiving discharge teaching for esophageal cancer and starting radiation therapy. What instruction should the healthcare provider include?

• A. Remove dye markings after each radiation treatment
• B. Apply a warm compress to the irradiated site
• C. Wear clothing over the area of radiation treatment
• D. Use a washcloth to bathe the treatment area

Correct answer: C

Rationale: The correct instruction for a patient starting radiation therapy for esophageal cancer is to wear clothing over the area of radiation treatment. This helps to prevent irritation and protect the skin. Removing dye markings after each treatment (choice A) is unnecessary and not typically part of the patient's self-care. Applying a warm compress (choice B) can exacerbate skin irritation caused by radiation. Using a washcloth to bathe the treatment area (choice D) can potentially irritate the skin further, making it important to avoid.

2. A nurse is assessing a client who is 12 hours post-surgery. The client has an indwelling urinary catheter, and the nurse notes a urinary output of 15 mL/hr. Which of the following interventions should the nurse implement first?

• A. Irrigate the catheter
• B. Assess the patency of the catheter
• C. Increase the IV fluid rate
• D. Notify the provider

Correct answer: B

Rationale: The nurse should first assess the patency of the catheter to ensure that the low output is not caused by a blockage. It is crucial to rule out any obstructions before considering other interventions. Irrigating the catheter without verifying patency may worsen the situation if there is a blockage. Increasing IV fluid rate may not address the underlying issue if the problem lies with the catheter. Notifying the provider should come after ensuring the catheter's patency.

3. What teaching points are important for the nurse to discuss with a client with hearing loss who has been fitted for a hearing aid?

• A. Use the highest setting to promote full auditory comprehension
• B. Use mild soap and water to clean the ear mold
• C. Turn the hearing aid off to conserve battery life during hours of sleep only
• D. Immerse the hearing aid in saline solution to keep it hygienic

Correct answer: B

Rationale: The correct teaching point for a client with hearing loss who has been fitted for a hearing aid is to use mild soap and water to clean the ear mold. It is important to keep the ear mold clean to prevent infections and maintain proper functioning. Choice A is incorrect because using the highest setting can lead to discomfort and may not be necessary for all situations. Choice C is incorrect as the hearing aid should generally be turned off when not in use, not just during sleep, to conserve battery life. Choice D is incorrect as immersing the hearing aid in saline solution can damage the device; it should be kept dry to prevent malfunction.

4. A nurse is teaching about measures to promote sleep with insomnia. What statement indicates understanding?

• A. Take naps throughout the day
• B. Reduce fluid intake 2 hours before bedtime
• C. Drink coffee to help stay awake
• D. Increase screen time before bed

Correct answer: B

Rationale: The correct answer is B. Reducing fluid intake before bedtime helps prevent interruptions in sleep due to bathroom visits, which is crucial for individuals with insomnia. Taking naps throughout the day (choice A) may disrupt nighttime sleep. Drinking coffee (choice C) is counterproductive as it contains caffeine, which can interfere with falling asleep. Increasing screen time before bed (choice D) can negatively impact sleep quality due to the stimulating effects of screens.

5. A nurse is providing discharge teaching to a client who has schizophrenia and is starting therapy with clozapine. Which of the following is the highest priority to report to the provider?

• A. Constipation
• B. Blurred vision
• C. Fever
• D. Dry mouth

Correct answer: C

Rationale: The correct answer is C: Fever. Clozapine can cause agranulocytosis, a serious condition that leads to infections. Fever may indicate an underlying infection, a potentially life-threatening complication, and must be reported immediately to the provider for further evaluation and management. Choice A (Constipation) is a common side effect of clozapine but is not as urgent as fever. Blurred vision (Choice B) and dry mouth (Choice D) are side effects of clozapine but are not indicative of a life-threatening condition like agranulocytosis.

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