Nursing Elites

1. 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.

2. A client who has had two episodes of bacterial cystitis in the last 6 months is being assessed by a nurse. Which questions should the nurse ask? (Select all that apply.)

• A. How much water do you drink every day?
• B. Do you take estrogen replacement therapy?
• C. Does anyone in your family have a history of cystitis?
• D. All of the Above

Correct answer: D

Rationale: The correct answers are all of the above (D). Asking about fluid intake (choice A) is important as it can affect the risk of cystitis. Estrogen levels (choice B) can also impact the likelihood of recurrent cystitis. Family history (choice C) is relevant as certain genetic factors can predispose individuals to cystitis. Cranberry juice, not grapefruit or orange juice, has been found to reduce the risk of bacterial cystitis by increasing the acidic pH. Therefore, choices A, B, and C are all pertinent questions to ask during the assessment of a client with recurrent bacterial cystitis.

3. When working with a large population of African-American clients at a community health center, which priority assessment should a nurse include?

• A. Measure height and weight.
• B. Assess blood pressure.
• C. Observe for any signs of abuse.
• D. Ask about medications.

Correct answer: B

Rationale: Assessing blood pressure is the priority assessment when working with a population of African-American clients due to the high prevalence of hypertension in this group. African Americans have a higher risk of hypertension, which can lead to complications like end-stage renal disease. Monitoring blood pressure allows for the early detection and management of hypertension. While measuring height and weight, observing for signs of abuse, and asking about medications are important assessments, assessing blood pressure is crucial in this context to address the specific health needs of African-American clients.

4. What is the priority intervention for a patient with a suspected myocardial infarction (MI)?

• A. Administering oxygen.
• B. Administering nitroglycerin.
• C. Administering aspirin.
• D. Administering morphine.

Correct answer: A

Rationale: Administering oxygen is the priority intervention for a patient with a suspected myocardial infarction to improve oxygenation. Oxygen helps ensure an adequate oxygen supply to the heart muscle, reducing the workload on the heart. Nitroglycerin and aspirin are important interventions in the treatment of MI; however, oxygen administration takes precedence to ensure adequate oxygenation. Morphine may be considered for pain relief, but it is not the initial priority in the treatment of a suspected MI.

5. After delegating to an unlicensed assistive personnel (UAP) the task of completing a bladder scan examination for a client, the nurse evaluates the UAP’s performance. Which action by the UAP indicates the nurse must provide additional instructions when delegating this task?

• A. Selecting the female icon for all female clients and the male icon for all male clients
• B. Explaining to the client, 'This test measures the amount of urine in your bladder.'
• C. Applying ultrasound gel to the scanning head and cleaning it after use
• D. Taking at least two readings using the aiming icon to position the scanning head

Correct answer: A

Rationale: The correct answer is A because the UAP should select the female icon for women who have not had a hysterectomy to allow the scanner to subtract the volume of the uterus from readings. If a woman has had a hysterectomy, the UAP should choose the male icon. Choice B is incorrect as it is essential for the UAP to explain the procedure to the client to ensure understanding. Choice C is incorrect because applying ultrasound gel to the scanning head and cleaning it after use are appropriate actions. Choice D is incorrect as it is necessary for the UAP to take at least two readings using the aiming icon to position the scanning head accurately for an effective bladder scan examination.

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