Nursing Elites

1. The client is recovering from a percutaneous renal biopsy. Which data indicate that the client is complying with client teaching?

• A. The client lies flat in the supine position for 12 hours
• B. The client continues oral fluids restriction while on bed rest
• C. The client’s family changed the dressing on return to the room
• D. The family activates the patient-controlled analgesia pump

Correct answer: A

Rationale: The correct answer is A. Lying flat in the supine position for 12 hours after a renal biopsy helps prevent bleeding, which is crucial for the client's recovery. This position aids in applying pressure to the biopsy site, reducing the risk of bleeding and ensuring optimal healing. Choices B, C, and D do not directly relate to compliance with client teaching after a renal biopsy. Continuing oral fluids restriction, changing the dressing, or activating a patient-controlled analgesia pump are not specific instructions aimed at promoting recovery and preventing complications post renal biopsy.

2. Under the health services support area concept, how is the medical care under the MEDCOM divided?

• A. Six geographical regions of the United States with command authority in each region
• B. Five levels of health service support, each providing different levels of health care services
• C. Primary and secondary health care regions, each containing a MEDDAC or MEDCEN
• D. Eight geographical areas of responsibility designated as health services support regions, each of which is subdivided into two or more health service areas

Correct answer: D

Rationale: The correct answer is D. Under the health services support area concept, medical care under MEDCOM is divided into eight geographical areas of responsibility. Each of these areas is designated as a health services support region, and they are further subdivided into two or more health service areas. Choices A, B, and C are incorrect because they do not accurately describe how the medical care under MEDCOM is divided.

3. The use of the antibiotic neomycin may decrease the absorption of:

• A. Iron, copper, and zinc
• B. Protein and amino acids
• C. Fat-soluble vitamins
• D. Water-soluble vitamins

Correct answer: C

Rationale: The correct answer is C. Neomycin can interfere with the absorption of fat-soluble vitamins such as vitamins A, D, E, and K. Choice A is incorrect because neomycin does not affect the absorption of iron, copper, and zinc. Choice B is incorrect as neomycin does not impact the absorption of protein and amino acids. Choice D is also incorrect as neomycin does not decrease the absorption of water-soluble vitamins like vitamin C and the B vitamins.

4. The nurse has given post-procedure instructions to a client who underwent a colonoscopy. Evaluation of learning would be evident if the client makes which statement(s)?

• A. All of the above
• B. “My abdominal muscles may be tender because of the procedure.”
• C. “My diet should be light at first, and then I can progress to a regular diet.”
• D. “It is normal to feel gassy or bloated for a short while after the procedure.”

Correct answer: A

Rationale: The correct answer is A: "All of the above." Evaluation of learning after a colonoscopy would be evident if the client mentions all the statements provided. Mild tenderness in the abdominal muscles, starting with a light diet and progressing to a regular diet, and experiencing gas or bloating temporarily are all expected after a colonoscopy. Therefore, all the statements are correct in demonstrating the client's understanding of the post-procedure instructions. Choices B, C, and D provide accurate information about the expected outcomes following a colonoscopy, making them incorrect answers individually but correct when combined as option A.

5. The nurse is caring for a client whose religious background is Seventh Day Adventist (Church of GOD). Which nursing action(s) are most appropriate in terms of providing for the dietary needs of this client? Select all that apply.

• A. Providing snacks between meals
• B. Removing coffee from the breakfast tray
• C. Ensuring that there is no pork on the dinner tray
• D. A, B

Correct answer: D

Rationale: Seventh Day Adventists typically avoid caffeine and pork, so providing snacks between meals and removing coffee from the breakfast tray are appropriate actions to meet the dietary needs of this client. Providing snacks helps ensure the client has options that align with their dietary restrictions, while removing coffee respects their avoidance of caffeine. Ensuring that there is no pork on the dinner tray is also crucial as pork is typically avoided in their diet, making choice C correct. Therefore, choices A and B are correct, making D the most appropriate selection.

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