Nursing Elites

1. A patient reports nausea and vomiting after chemotherapy. What is the nurse's priority action?

• A. Administer an antiemetic as prescribed.
• B. Encourage the patient to eat small, frequent meals.
• C. Provide the patient with anti-nausea wristbands.
• D. Encourage the patient to rest after eating.

Correct answer: A

Rationale: The correct answer is to administer an antiemetic as prescribed. Chemotherapy-induced nausea and vomiting can be distressing for patients. Administering an antiemetic helps alleviate these symptoms effectively. Choice B, encouraging the patient to eat small, frequent meals, may be helpful for other gastrointestinal issues but is not the priority when the patient is experiencing nausea and vomiting. Choice C, providing anti-nausea wristbands, may offer some relief but is not as direct and immediate as administering an antiemetic. Choice D, encouraging the patient to rest after eating, is not the priority in this situation where the focus should be on managing the nausea and vomiting.

2. A client with a do-not-resuscitate (DNR) order has requested resuscitation during a family visit. How should the nurse respond?

• A. Follow the client's wishes and start resuscitation.
• B. Explain that the DNR must be honored.
• C. Ignore the client's request.
• D. Consult with the family regarding the decision.

Correct answer: B

Rationale: The correct answer is B. Nurses have a legal and ethical obligation to honor a client's do-not-resuscitate (DNR) order, regardless of any request for resuscitation during a family visit. It is crucial for the nurse to explain to the client that the DNR order must be respected. Choice A is incorrect because starting resuscitation against the client's documented wishes goes against the principle of autonomy. Choice C is inappropriate as it disregards the client's autonomy and legal directives. Choice D is not the best option as the nurse should prioritize honoring the client's decision as per the DNR order.

3. A patient with chronic kidney disease has been prescribed a low-protein diet. What is the nurse's priority intervention?

• A. Encourage the patient to eat small, frequent meals.
• B. Monitor the patient's intake and output.
• C. Educate the patient on the benefits of a low-protein diet.
• D. Monitor the patient's protein intake closely.

Correct answer: D

Rationale: The correct answer is to monitor the patient's protein intake closely. In patients with chronic kidney disease on a low-protein diet, monitoring protein intake is crucial to prevent complications such as malnutrition or inadequate nutrient intake. Encouraging small, frequent meals (Choice A) can be beneficial but is not the priority over monitoring protein intake. Monitoring intake and output (Choice B) is important but does not directly address the specific focus on protein intake. Educating the patient on the benefits of a low-protein diet (Choice C) is essential but not as immediate as monitoring the actual protein intake.

4. Which of the following statements reflects the principles of sterile technique?

• A. Sterile objects that come in contact with unsterile objects are to be considered contaminated.
• B. Items in a sterile package must be used immediately once the package has been opened; otherwise, they are considered contaminated.
• C. Any part of a sterile field that hangs below the top of the table is sterile as long as it is not touched.
• D. The edge of a sterile field and a border 1 inch (2.5 cm) inward is unsterile.

Correct answer: A

Rationale: The correct statement reflecting the principles of sterile technique is that sterile objects that come in contact with unsterile objects are considered contaminated. This principle is crucial in maintaining asepsis during medical procedures. Choice B is incorrect because items in a sterile package should only be used if they remain sterile; opening the package does not automatically contaminate the items. Choice C is incorrect as any part of a sterile field that hangs below the top of the table is considered unsterile. Choice D is incorrect as the edge of a sterile field and a border inward are typically considered unsterile to maintain the integrity of the sterile area.

5. What are the priority nursing assessments for a patient who has just undergone major surgery?

• A. Providing analgesia as prescribed
• B. Monitoring for signs of infection
• C. Assessing the surgical site for bleeding
• D. Monitoring the patient's vital signs

Correct answer: B

Rationale: The correct answer is to monitor for signs of infection. After major surgery, one of the priority nursing assessments is to watch for signs of infection, such as increased temperature, redness, swelling, or drainage at the surgical site. While providing analgesia is important for pain management, monitoring for infection takes precedence as it can lead to severe complications if not detected early. Assessing the surgical site for bleeding is crucial but is usually more relevant immediately after surgery. Monitoring the patient's vital signs is essential, but the specific focus on infection assessment is crucial in the immediate postoperative period.

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