Nursing Elites

1. A client is being taught about self-catheterization in the home setting. Which statements should the nurse include in this client’s teaching? (Select all that apply.)

• A. Wash your hands before and after self-catheterization.
• B. Use lubricant on the tip of the catheter before insertion.
• C. A & B
• D. Self-catheterize at least twice a day or every 12 hours.

Correct answer: C

Rationale: In teaching a client about self-catheterization, it is essential to emphasize proper hand hygiene before and after the procedure to prevent infections. Using lubricant on the catheter helps with insertion and reduces discomfort. Therefore, statements A and B are correct and should be included in the client's teaching. Option D is incorrect because self-catheterization frequency should be individualized based on the client's needs, and a specific time frame like every 12 hours may not be suitable for everyone. Choosing a smaller lumen catheter is preferred over a larger one. Self-catheterization should not be limited to a specific time frame but should be based on the individual's needs and voiding patterns. Therefore, option C is the correct choice as it includes the two essential statements for teaching self-catheterization in the home setting.

2. The nurse is obtaining a health history from a new client who has a history of kidney stones. Which statement by the client indicates an increased risk for renal calculi?

• A. Eats a vegetarian diet with cheese 2 to 3 times a day
• B. Experiences additional stress since adopting a child
• C. Jogs more frequently than usual daily routine
• D. Drinks several bottles of carbonated water daily

Correct answer: D

Rationale: The correct answer is D. Drinking several bottles of carbonated water daily may contribute to renal calculi formation due to the high mineral content. Carbonated drinks can increase the risk of kidney stones due to their high levels of phosphoric acid and caffeine, which can lead to the formation of crystals in the urine. Choices A, B, and C are less likely to directly contribute to an increased risk of renal calculi compared to the excessive consumption of carbonated water.

3. A patient has a serum potassium level of 2.7 mEq/L. The patient’s provider has determined that the patient will need 200 mEq of potassium to replace serum losses. How will the nurse caring for this patient expect to administer the potassium?

• A. As a single-dose 200 mEq oral tablet
• B. As an intravenous bolus over 15 to 20 minutes
• C. In an intravenous solution at a rate of 10 mEq/hour
• D. In an intravenous solution at a rate of 45 mEq/hour

Correct answer: C

Rationale: For a patient with severe hypokalemia with a serum potassium level of 2.7 mEq/L requiring 200 mEq of potassium replacement, the appropriate route of administration would be intravenous. Potassium chloride should be administered slowly to prevent adverse effects; therefore, the correct option is to administer the potassium in an intravenous solution at a rate of 10 mEq/hour. Choices A and B are incorrect because potassium should not be given as a single-dose oral tablet or as an intravenous bolus over a short period of time due to the risk of adverse effects. Choice D is also incorrect as the rate of 45 mEq/hour exceeds the recommended maximum infusion rate for adults with a serum potassium level greater than 2.5 mEq/L, which is 10 mEq/hour.

4. A client with polycystic kidney disease (PKD) is being discharged. Which statements should the nurse include in this client’s discharge teaching? (Select all that apply.)

• A. Take your blood pressure every morning.
• B. Weigh yourself at the same time each day.
• C. Contact your provider if you have visual disturbances.
• D. All of the above

Correct answer: D

Rationale: A client with polycystic kidney disease (PKD) should be educated on monitoring their blood pressure daily and weighing themselves consistently to detect any changes promptly. It is essential to contact the healthcare provider if visual disturbances occur, as this could indicate a complication such as a berry aneurysm associated with PKD. Foul-smelling or bloody urine should also prompt notification to the provider as they could signify urinary tract infections or glomerular injury. Choices A, B, and C are correct as they address crucial aspects of managing PKD and its potential complications. Choices A and B help in monitoring for changes in blood pressure and fluid status, while choice C focuses on detecting possible neurological complications. Choices A, B, and C are relevant to PKD management and should be included in the client's discharge teaching. Choices that mention diarrhea and renal stones are not directly associated with PKD; therefore, teaching related to these conditions would be irrelevant in this context.

5. In a patient with asthma, which of the following is a primary goal of treatment?

• A. Improving oxygenation.
• B. Reducing inflammation.
• C. Improving airflow.
• D. Reducing airway constriction.

Correct answer: C

Rationale: The primary goal in the treatment of asthma is to improve airflow. Asthma is characterized by airway inflammation, constriction, and increased mucus production, leading to airflow limitation. Improving airflow helps ensure adequate oxygenation and reduces symptoms. While reducing inflammation and airway constriction are important aspects of asthma management, the primary goal is to optimize airflow to improve respiratory function and quality of life.

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