Nursing Elites

1. A patient on long-term steroid therapy should be monitored for which condition?

• A. Hyperglycemia
• B. Hypothyroidism
• C. Hypertension
• D. Osteoporosis

Correct answer: D

Rationale: Corrected Rationale: Patients on long-term steroid therapy should be monitored for osteoporosis due to the medication's potential to decrease bone density. Choices A, B, and C are incorrect. While long-term steroid therapy can also lead to hyperglycemia, hypothyroidism, and hypertension, the primary concern and most common risk associated with prolonged steroid use is osteoporosis.

2. What causes hepatic encephalopathy?

• A. Buildup of ammonia in the body
• B. Buildup of urea in the body
• C. Fatty infiltration of the liver
• D. Jaundice

Correct answer: A

Rationale: Hepatic encephalopathy is caused by the buildup of ammonia in the body. Ammonia, a byproduct of protein metabolism, normally gets converted to urea in the liver for excretion. However, in liver dysfunction, such as cirrhosis, the liver cannot effectively convert ammonia to urea, leading to its accumulation in the body and subsequently causing hepatic encephalopathy. Choices B, C, and D are incorrect as they do not directly relate to the pathophysiology of hepatic encephalopathy.

3. Listed below are five categories that identify the responsibilities of the practical nurse manager in personnel management. Which of these categories is most appropriate for the task 'Know what your soldiers are doing during duty hours'?

• A. Accountability
• B. Personal/professional development
• C. Individual training
• D. Military appearance/physical condition

Correct answer: A

Rationale: The correct answer is 'Accountability.' This choice is the most appropriate for the task 'Know what your soldiers are doing during duty hours' as it directly relates to being responsible for and knowing the actions and whereabouts of individuals under supervision. 'Personal/professional development' (choice B) focuses on growth and advancement, 'Individual training' (choice C) pertains to specific skill development, and 'Military appearance/physical condition' (choice D) deals with the physical presentation and health of soldiers, none of which directly address the task of knowing soldiers' activities during duty hours.

4. The HCP orders cultures of the urethral urine, bladder urine, and prostatic fluid. Which instructions would the nurse teach to achieve the first two (2) specimens?

• A. Collect the first 15 mL in one jar and then the next 50 mL in another
• B. Collect three (3) early morning, clean voided urine specimens
• C. Collect the specimens after the HCP massages the prostate
• D. Collect a routine urine specimen for analysis

Correct answer: A

Rationale: The correct answer is to collect the first 15 mL in one jar and then the next 50 mL in another. This method allows for accurate cultures of urethral and bladder urine. Choice B is incorrect because it does not specify the correct method for collecting urethral and bladder urine separately. Choice C is incorrect because prostatic fluid is a separate specimen that does not require prostatic massage for collection. Choice D is incorrect as it suggests collecting a routine urine specimen, which does not fulfill the HCP's orders for specific cultures.

5. What intervention should the nurse implement for the client who has an ileal conduit?

• A. Pouch the stoma with a one-inch margin around the stoma
• B. Refer the client to the United Ostomy Association for discharge teaching
• C. Report to the healthcare provider any decrease in urinary output
• D. Monitor the stoma for signs and symptoms of infection every shift

Correct answer: C

Rationale: The correct intervention for a client with an ileal conduit is to report any decrease in urinary output to the healthcare provider. Decreased urinary output in these clients may indicate a blockage or another complication, which requires immediate attention. Monitoring the stoma for signs of infection (Choice D) is important but not the priority when compared to a decrease in urinary output. Pouching the stoma with a one-inch margin around it (Choice A) is incorrect as it does not address the issue of decreased urinary output. Referring the client to the United Ostomy Association (Choice B) is not necessary in this immediate situation where a potential complication is suspected.

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