Nursing Elites

1. 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: To obtain accurate cultures of urethral and bladder urine, the nurse should instruct the patient to collect the first 15 mL of urine in one container and the subsequent 50 mL in another. This method ensures that the specimens are separated appropriately for analysis. Choices B, C, and D are incorrect because collecting three early morning urine specimens, massaging the prostate, or collecting a routine urine specimen would not provide the specific separation of urethral and bladder urine required for this particular test.

2. A patient with Crohn’s disease is experiencing diarrhea. Which dietary recommendation is appropriate?

• A. High-fiber diet
• B. Low-residue diet
• C. High-fat diet
• D. High-protein diet

Correct answer: B

Rationale: A low-residue diet is appropriate for a patient with Crohn’s disease experiencing diarrhea because it helps reduce bowel movements and manage symptoms. Choice A, a high-fiber diet, can exacerbate diarrhea in Crohn’s disease due to increased bulk and fermentation in the gut. Choice C, a high-fat diet, may be hard to digest and can worsen symptoms. Choice D, a high-protein diet, can be taxing on the digestive system and may not provide the relief needed for diarrhea in Crohn’s disease.

3. Which of the following is a common side effect of the drug metformin?

• A. Weight loss
• B. Weight gain
• C. Drowsiness
• D. Hypertension

Correct answer: A

Rationale: The correct answer is A, weight loss. Metformin is commonly associated with weight loss rather than weight gain. Metformin works by decreasing glucose production in the liver and improving insulin sensitivity, which can lead to weight loss in some individuals. Choices B, C, and D are incorrect. Weight gain is not a typical side effect of metformin. Drowsiness and hypertension are also not commonly associated with metformin use.

4. The nurse is caring for the client one day postoperative sigmoid colostomy operation. Which independent nursing intervention should the nurse implement?

• A. Change the infusion rate of the intravenous fluid
• B. Encourage the client to discuss his or her feelings
• C. Administer opioid narcotic medications for pain management
• D. Assist the client out of bed to sit in the chair twice daily

Correct answer: D

Rationale: Assisting the client to sit in a chair is an essential nursing intervention postoperatively as it helps promote circulation, prevent complications like blood clots, and aids in the recovery process. Changing the infusion rate of intravenous fluid (Choice A) requires a physician's order and is not an independent nursing intervention. Encouraging the client to discuss feelings (Choice B) is important for emotional support but not as crucial as physical care immediately postoperatively. Administering opioid narcotic medications (Choice C) for pain management should be based on a prescribed schedule and assessment rather than being an independent nursing action.

5. The hypertonicity of the muscles in an infant with cerebral palsy causes scissoring of the legs. The nurse teaches the mother that the preferred way to carry the infant is in a sitting position:

• A. Astride one of her hips
• B. Strapped in an infant seat
• C. Wrapped tightly in a blanket
• D. Under the arm using a football hold

Correct answer: A

Rationale: Carrying the infant astride one of her hips helps keep the legs apart and can help reduce muscle tightness. This position allows for better support and alignment, preventing further muscle contractures. Strapping the infant in an infant seat, wrapping tightly in a blanket, or using the football hold under the arm would not provide the same benefits and may even exacerbate muscle tightness in a child with cerebral palsy.

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