Nursing Elites

1. In some hip surgeries, an epidural catheter for Fentanyl epidural analgesia is given. What is your nursing priority care in such a case?

• A. Instruct the client to observe strict bed rest
• B. Check for epidural catheter drainage
• C. Administer analgesia through the epidural catheter as prescribed
• D. Assess respiratory rate carefully

Correct answer: D

Rationale: The nursing priority care in a case where an epidural catheter for Fentanyl epidural analgesia is given during hip surgeries is to assess the respiratory rate carefully. Respiratory depression is a potential side effect of Fentanyl, especially when administered epidurally. Monitoring the respiratory rate is crucial to detect any signs of respiratory distress promptly. Instructing the client to observe strict bed rest (Choice A) may be necessary but is not the priority over ensuring respiratory function. Checking for epidural catheter drainage (Choice B) and administering analgesia through the epidural catheter as prescribed (Choice C) are important aspects of care, but ensuring adequate ventilation takes precedence to prevent complications.

2. A healthcare professional is reviewing the lab findings of a client who has Clostridium Difficile. Which of the following findings should indicate to the healthcare professional that the client is experiencing Fluid Volume Deficit?

• A. Hct 53%
• B. Potassium 3.5
• C. Sodium 145
• D. HbA1c 5

Correct answer: A

Rationale: An elevated hematocrit level (Hct 53%) indicates hemoconcentration, a sign of fluid volume deficit. Hct measures the percentage of red blood cells in the blood and increases when there is a decrease in plasma volume, as seen in fluid volume deficit. Choices B, C, and D do not directly relate to fluid volume status. Potassium and sodium levels are more indicative of electrolyte imbalances, while HbA1c reflects average blood sugar levels over the past 2-3 months and is not specific to fluid volume status.

3. A client is planning eating strategies with a nurse who has nausea from equilibrium imbalance. Which of the following strategies should the nurse recommend?

• A. Encourage the client to eat, even if nauseated.
• B. Provide low-fat carbohydrates with meals.
• C. Limit fluid intake between meals.
• D. Serve hot foods at mealtime.

Correct answer: B

Rationale: The correct answer is B: Provide low-fat carbohydrates with meals. Low-fat carbohydrates are easier to digest and can help manage nausea without overloading the digestive system. Encouraging the client to eat even if nauseated (Choice A) may worsen their symptoms. Limiting fluid intake between meals (Choice C) may lead to dehydration, which can exacerbate nausea. Serving hot foods at mealtime (Choice D) may not necessarily address the underlying issue of equilibrium imbalance causing nausea.

4. During the phallic stage, with which parent must the child identify?

• A. The same-sex parent
• B. The opposite-sex parent
• C. The mother or the primary caregiver
• D. Both parents

Correct answer: A

Rationale: According to Freud's psychosexual development theory, during the phallic stage (approximately ages 3 to 6), the child starts to identify with the parent of the same sex. This identification is a crucial part of the child's development and is believed to influence their adult behavior. The process involves the child adopting the characteristics, attitudes, and values of the same-sex parent. Choice B, C, and D are incorrect as they do not align with Freud's theory of the phallic stage of psychosexual development.

5. A nurse is providing discharge teaching for a client who has acute pancreatitis and has a prescription for fat-soluble vitamin supplements. The nurse should instruct the client to take a supplement for which of the following?

• A. Vitamin A
• B. Vitamin B1
• C. Vitamin C
• D. Vitamin B12

Correct answer: A

Rationale: In acute pancreatitis, malabsorption of fat-soluble vitamins can occur due to pancreatic enzyme insufficiency. Vitamin A is a fat-soluble vitamin that may need supplementation in this case. Vitamin B1 (thiamine), Vitamin C, and Vitamin B12 are water-soluble vitamins and are not typically affected by pancreatic enzyme insufficiency in acute pancreatitis. Therefore, the correct supplement for the client with acute pancreatitis is Vitamin A.

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