Nursing Elites

1. When teaching a client how to perform self-catheterization, which of the following instructions should be included?

• A. Use sterile gloves during the procedure.
• B. Clean the catheter with alcohol after each use.
• C. Insert the catheter 2-4 inches into the urethra.
• D. Perform the procedure every 8 hours.

Correct answer: C

Rationale: To ensure effective drainage, the catheter should be inserted 2-4 inches into the urethra. This length allows the catheter to reach the bladder, bypass the urethral sphincters, and ensure proper drainage without causing discomfort or injury. Using sterile gloves, cleaning the catheter with alcohol, and performing the procedure every 8 hours are not accurate instructions for self-catheterization.

2. Prior to administering a blood transfusion, what should the healthcare professional do first?

• A. Prime the IV tubing with normal saline.
• B. Verify the client's identity.
• C. Obtain the blood product from the blood bank.
• D. Check the client's vital signs.

Correct answer: B

Rationale: Verifying the client's identity is the essential initial step before administering a blood transfusion. This action is crucial to confirm that the correct blood product is being administered to the right client, thereby preventing any potential errors or adverse reactions. Ensuring patient safety is paramount in healthcare, and verifying the client's identity is a fundamental safety measure that should always be prioritized.

3. A healthcare professional is preparing to administer an intradermal injection. Which of the following actions should the professional take?

• A. Use a tuberculin syringe.
• B. Insert the needle at a 45-degree angle.
• C. Use a 1-inch needle.
• D. Aspirate before injecting.

Correct answer: A

Rationale: When administering an intradermal injection, a tuberculin syringe is the appropriate choice due to its small size and precise measurement markings, which are essential for accurately delivering the medication into the dermis layer of the skin. Using a 1-inch needle (choice C) is more common for subcutaneous injections, while inserting the needle at a 45-degree angle (choice B) is typical for intramuscular injections. Aspirating before injecting (choice D) is not necessary for intradermal injections, as the goal is to deliver the medication into the dermis rather than a blood vessel.

4. A client has been on bed rest for 3 days. Which of the following findings should the nurse identify as an indication that the client is ready to ambulate?

• A. The client uses a walker to move from the bed to the chair.
• B. The client has a strong cough.
• C. The client can bear weight on both legs.
• D. The client has a normal respiratory rate.

Correct answer: C

Rationale: The ability to bear weight on both legs indicates muscle strength and stability necessary for ambulation. This skill is crucial for the client to support their body weight and move independently when standing or walking. Choices A, B, and D are incorrect because using a walker, having a strong cough, or having a normal respiratory rate do not directly indicate the readiness to ambulate. The key factor in determining readiness for ambulation is the client's ability to bear weight on both legs, demonstrating the necessary strength for standing and walking.

5. A client with hypothyroidism is being taught about dietary management. Which statement by the client indicates an understanding of the teaching?

• A. I should increase my intake of iodine-rich foods.
• B. I should decrease my intake of iodine-rich foods.
• C. I should increase my intake of potassium-rich foods.
• D. I should decrease my intake of sodium-rich foods.

Correct answer: A

Rationale: The correct answer is A. Increasing intake of iodine-rich foods is beneficial for clients with hypothyroidism as iodine is essential for thyroid hormone synthesis. Adequate iodine intake helps to support thyroid function in individuals with hypothyroidism, making choice A the most appropriate response indicating an understanding of the dietary management for this condition. Choices B, C, and D are incorrect because decreasing iodine-rich foods, increasing potassium-rich foods, or decreasing sodium-rich foods are not the recommended dietary modifications for hypothyroidism. In fact, decreasing iodine-rich foods could exacerbate hypothyroidism due to the essential role of iodine in thyroid hormone production.

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