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. 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 A because tapering glucocorticoids is crucial to prevent adrenal insufficiency, which can occur if the medication is stopped abruptly. Choice B is incorrect as it refers to dose adjustments during stress or infection, not discontinuation. Choice C is incorrect because it does not specifically address the issue of stopping the medication. Choice D is not directly related to the management of glucocorticoid therapy for Addison’s disease.

3. Who typically collects blood specimens?

• A. The nurse
• B. Medical technologist
• C. Physician
• D. Phlebotomist

Correct answer: A

Rationale: Nurses typically collect blood specimens from patients as part of their everyday duties in medical settings. They are trained in venipuncture techniques and are responsible for ensuring that blood samples are properly obtained and labeled for diagnostic testing. Medical technologists process and analyze the blood specimens in the laboratory under the direction of a physician. Physicians are not commonly involved in the direct collection of blood specimens. While phlebotomists are specialized professionals trained to draw blood, in many medical settings, nurses perform this task as part of their responsibilities.

4. Listed below are five categories that identify the responsibilities of the practical nurse manager in personnel management. Which of these categories is most appropriate for the task of 'Educate personnel on UCMJ'?

• A. Accountability
• B. Personal/professional development
• C. Individual training
• D. Military appearance/physical condition

Correct answer: B

Rationale: The correct answer is 'B: Personal/professional development.' Educating personnel on the Uniform Code of Military Justice (UCMJ) falls under the realm of personal/professional development, as it aims to enhance the knowledge and skills of individuals regarding military laws and regulations. Choice A, 'Accountability,' focuses more on responsibility and answerability rather than education. Choice C, 'Individual training,' is more specific to skill development and job-related learning rather than legal education. Choice D, 'Military appearance/physical condition,' pertains to maintaining physical standards and appearance, which is unrelated to educating personnel on UCMJ.

5. The nurse is told in report that the client has aortic stenosis. Which anatomical position should the nurse auscultate to assess the murmur?

• A. Second intercostal space, right sternal border
• B. Erb’s point
• C. Second intercostal space, left sternal border
• D. Fourth intercostal space, left sternal border

Correct answer: A

Rationale: The correct answer is A: Second intercostal space, right sternal border. The aortic valve is best auscultated at the second intercostal space, right sternal border, where the murmur of aortic stenosis is heard most clearly. Choices B, C, and D are incorrect as they are not the recommended anatomical positions for auscultating the murmur of aortic stenosis.

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