Nursing Elites

1. When obtaining the health history of a client suspected of having bladder cancer, which question should the nurse ask to determine the client's risk factors?

• A. Do you smoke cigarettes?
• B. Do you consume alcohol?
• C. Do you use recreational drugs?
• D. Do you take any prescription drugs?

Correct answer: A

Rationale: The correct answer is A: 'Do you smoke cigarettes?' Smoking is a major risk factor for bladder cancer. Cigarette smoke contains harmful chemicals that can accumulate in the urine and damage the lining of the bladder, increasing the risk of developing cancer. Alcohol use, recreational drug use, and most prescription drugs are not directly linked to an increased risk of bladder cancer. It is important for the nurse to assess smoking history as a significant risk factor in determining the client's risk for bladder cancer.

2. The nurse is caring for a patient who is receiving isotonic intravenous (IV) fluids at an infusion rate of 125 mL/hour. The nurse performs an assessment and notes a heart rate of 102 beats per minute, a blood pressure of 160/85 mm Hg, and crackles auscultated in both lungs. Which action will the nurse take?

• A. Decrease the IV fluid rate and notify the provider.
• B. Increase the IV fluid rate and notify the provider.
• C. Request an order for a colloidal IV solution.
• D. Request an order for a hypertonic IV solution.

Correct answer: A

Rationale: The patient is showing signs of fluid volume excess, indicated by crackles in both lungs, increased heart rate, and elevated blood pressure. To address this, the nurse should decrease the IV fluid rate and notify the provider. Increasing the IV fluid rate would worsen fluid overload. Requesting colloidal or hypertonic IV solutions would exacerbate the issue by pulling more fluids into the intravascular space, leading to further volume overload.

3. A nurse contacts the healthcare provider after reviewing a client’s laboratory results and noting a blood urea nitrogen (BUN) of 35 mg/dL and a creatinine of 1.0 mg/dL. For which action should the nurse recommend a prescription?

• A. Intravenous fluids
• B. Hemodialysis
• C. Fluid restriction
• D. Urine culture and sensitivity

Correct answer: A

Rationale: The normal range for BUN is 10 to 20 mg/dL, and for creatinine, it is 0.6 to 1.2 mg/dL in males and 0.5 to 1.1 mg/dL in females. Creatinine is a more specific marker for kidney function compared to BUN. In this case, the client's creatinine level is within the normal range, indicating a non-renal cause for the elevated BUN. Dehydration is a common cause of increased BUN, so the appropriate action would be to recommend intravenous fluids to address the dehydration. Fluid restriction is not indicated as the client needs hydration. Hemodialysis is not appropriate for dehydration and is typically reserved for renal failure. The laboratory results do not suggest an infection, making a urine culture and sensitivity unnecessary in this scenario.

4. A healthcare professional reviews the allergy list of a client scheduled for an intravenous urography. Which client allergy should prompt urgent contact with the healthcare provider?

• A. Seafood
• B. Penicillin
• C. Bee stings
• D. Red food dye

Correct answer: A

Rationale: Clients with seafood allergies should alert healthcare professionals to urgently contact the healthcare provider before an intravenous urography. The standard dyes used in this procedure can trigger severe allergic reactions in individuals with seafood allergies. Penicillin, bee stings, and red food dye allergies do not pose a direct threat during intravenous urography, making them less critical for immediate intervention.

5. A client who underwent lobectomy 24 hours ago has not had any chest tube drainage for the past hour. What should the nurse do first?

• A. Contacts the physician
• B. Checks for kinks in the drainage system
• C. Checks the client’s blood pressure and heart rate
• D. Connects a new drainage system to the client’s chest tube

Correct answer: B

Rationale: When a chest tube is not draining, the nurse's initial action should be to check for kinks or clots in the chest drainage system. This step helps to ensure the patency of the system and allows for proper drainage. Checking the client's blood pressure and heart rate is important but not the priority when addressing a lack of chest tube drainage. Contacting the physician is warranted if signs of respiratory distress or mediastinal shift are observed after ruling out kinks or clots. Connecting a new drainage system is done when the fluid chamber is full, following a specific procedure to maintain a closed system and prevent complications.

Similar Questions