Nursing Elites

1. An elderly male client reports to the clinic nurse that he is experiencing increasing nocturia with difficulty initiating his urine stream. He reports a weak urine flow and frequent dribbling after voiding. Which nursing action should be implemented?

• A. Obtain a urine specimen for culture and sensitivity.
• B. Encourage the client to schedule a digital rectal exam.
• C. Advise the client to maintain a voiding diary for one week.
• D. Instruct the client in effective techniques for cleansing the glans penis.

Correct answer: B

Rationale: Encouraging the client to schedule a digital rectal exam is the most appropriate nursing action in this situation. This exam can help evaluate for potential prostate enlargement or other issues contributing to the urinary symptoms described by the client. It is important to assess the prostate gland for any abnormalities that may be causing the urinary issues reported by the client.

2. Following a CVA, the nurse assesses that a client developed dysphagia, hypoactive bowel sounds, and a firm, distended abdomen. Which prescription for the client should the nurse question?

• A. Continuous tube feeding at 65 ml/hr via gastrostomy.
• B. Total parenteral nutrition to be infused at 125 ml/hour.
• C. Nasogastric tube connected to low intermittent suction.
• D. Metoclopramide (Reglan) intermittent piggyback.

Correct answer: A

Rationale: In a client with dysphagia, hypoactive bowel sounds, and a firm, distended abdomen post-CVA, continuous tube feeding at 65 ml/hr via gastrostomy may exacerbate abdominal distension and hypoactive bowel sounds. This situation requires immediate assessment and reevaluation before continuing with the prescription.

3. A patient with diabetes insipidus is prescribed desmopressin. What is the primary purpose of this medication?

• A. Increase urine output
• B. Reduce blood sugar levels
• C. Decrease urine output
• D. Lower blood pressure

Correct answer: C

Rationale: Desmopressin is prescribed to decrease urine output in patients with diabetes insipidus. It works by increasing water reabsorption in the kidneys, helping to control fluid balance in the body.

4. A patient with hyperthyroidism is to receive radioactive iodine therapy. What information should the nurse include in the patient teaching plan?

• A. Avoid close contact with pregnant women for one week.
• B. Take iodine supplement daily.
• C. Restrict fluid intake to 1 liter per day.
• D. Use disposable utensils for all meals.

Correct answer: A

Rationale: The correct answer is to avoid close contact with pregnant women for one week. This precaution is essential to prevent radiation exposure to vulnerable populations. Pregnant women and small children are more sensitive to radiation, making it crucial for patients undergoing radioactive iodine therapy to avoid close contact with them for a specified period. Choices B, C, and D are incorrect because taking iodine supplements daily is not necessary for patients receiving radioactive iodine therapy. Restricting fluid intake to 1 liter per day is not a standard recommendation for radioactive iodine therapy. Using disposable utensils for all meals is not a specific precaution related to radioactive iodine therapy.

5. The client with newly diagnosed hypertension is being taught about lifestyle modifications. Which recommendation should be made?

• A. Increase your intake of saturated fats.
• B. Limit your alcohol intake to two drinks per day.
• C. Engage in at least 150 minutes of moderate exercise per week.
• D. Use table salt liberally to season your food.

Correct answer: C

Rationale: Engaging in at least 150 minutes of moderate exercise per week is a key lifestyle modification recommended for individuals with hypertension. Regular exercise helps manage blood pressure, improve cardiovascular health, and overall well-being. It is important for the client to adopt a healthy lifestyle to control hypertension and reduce the risk of complications.

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