Nursing Elites

1. Enteral feedings may be appropriate for patients with:

• A. Acute cholecystitis
• B. Hepatic encephalopathy
• C. Ulcerative colitis in remission
• D. Acute exacerbation of Crohn’s disease

Correct answer: D

Rationale: Enteral feedings are commonly utilized for patients experiencing acute exacerbations of Crohn’s disease to provide necessary nutrition and rest the bowel. Choices A, B, and C are incorrect because enteral feedings are not typically indicated for acute cholecystitis, hepatic encephalopathy, or ulcerative colitis in remission.

2. What is the best position to measure the leg circumference of a client with bipedal edema?

• A. Dorsal recumbent
• B. Sitting
• C. Standing
• D. Supine

Correct answer: A

Rationale: When measuring the leg circumference of a client with bipedal edema, the best position to ensure accurate and consistent measurements is the dorsal recumbent position. This position allows the legs to be comfortably positioned, with the individual lying on their back and legs extended. This facilitates accurate measurement of the circumference without the influence of gravity. Sitting and standing positions may not provide optimal conditions for accurate leg circumference measurements as they may not allow the legs to be fully extended. The supine position, although similar to dorsal recumbent, may not provide the same level of comfort and accuracy in leg circumference measurement for a client with bipedal edema.

3. Performing and supervising therapeutic and preventive procedures that have been planned for a patient is part of which of the following steps for determining and fulfilling the nursing care needs of the patient?

• A. Evaluation
• B. Planning
• C. Implementation
• D. Assessment

Correct answer: C

Rationale: The correct answer is C: Implementation. Implementation in nursing care involves the actual performance and supervision of the planned therapeutic and preventive procedures for a patient. Evaluation (choice A) is the step where the effectiveness of the interventions is assessed. Planning (choice B) is the phase where the nursing care plan is developed based on the assessment. Assessment (choice D) is the initial step in the nursing process, involving data collection and analysis to determine the patient's needs.

4. The client has failed to conceive after many attempts over a three-year time period and asks the nurse, “I have tried everything. What should I do now?” Which statement is the nurse’s best response?

• A. Assess the intravenous fluids for rate and volume
• B. Change the surgical dressing every day at the same time
• C. Monitor the client’s medication levels daily
• D. Monitor the percentage of each meal eaten

Correct answer: A

Rationale: The nurse's best response should focus on providing empathetic support and guiding the client to explore further options, such as fertility specialists or treatments. Assessing intravenous fluids for rate and volume is not relevant to the client's concern about infertility. Changing surgical dressing, monitoring medication levels, and tracking meal intake are all unrelated to the client's fertility issues.

5. Which nursing instruction should the nurse discuss with the client who is receiving glucocorticoids for Addison’s disease?

• A. Discuss the importance of tapering medications when discontinuing medication
• B. Explain that the dose will need to be decreased during times of stress or infection
• C. Instruct the client to take medication on an empty stomach with a glass of water
• D. Encourage the client to wear a MedicAlert bracelet and carry a card in the wallet

Correct answer: A

Rationale: The correct answer is to discuss the importance of tapering medications when discontinuing medication. Tapering glucocorticoids is crucial to prevent adrenal insufficiency, which can occur if the medication is stopped abruptly. Choice B is incorrect because it focuses on adjustments during stress or infection, not discontinuation. Choice C is unrelated to the management of glucocorticoids. Choice D is important for emergency identification but is not directly related to medication management.

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