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1. What are the key nursing considerations for a patient with a central venous catheter?
- A. Maintain sterility during dressing changes
- B. Change the dressing weekly
- C. Monitor blood pressure and fluid balance
- D. Monitor the catheter site for infection
Correct answer: A
Rationale: The correct answer is A: Maintain sterility during dressing changes. It is crucial to maintain sterility during dressing changes for patients with central venous catheters to prevent infections. Changing the dressing weekly (Choice B) is not frequent enough to prevent infections effectively. Monitoring blood pressure and fluid balance (Choice C) is important for overall patient care but not specific to central venous catheter management. While monitoring the catheter site for infection (Choice D) is important, the key consideration is to prevent infections through proper sterile techniques during dressing changes.
2. A nurse is providing discharge instructions for a client with diabetes. What is the most important teaching point?
- A. Monitor blood sugar levels weekly
- B. Administer insulin before meals as prescribed
- C. Take medication only when feeling unwell
- D. Monitor blood sugar only in the morning
Correct answer: B
Rationale: The correct answer is B: Administer insulin before meals as prescribed. This is the most important teaching point because insulin administration before meals helps manage blood sugar effectively in diabetic patients. Choice A is incorrect because monitoring blood sugar levels weekly may not provide timely information for managing diabetes. Choice C is incorrect as medications for diabetes should be taken as prescribed, not only when feeling unwell. Choice D is incorrect as blood sugar levels should be monitored at various times throughout the day, not just in the morning, to get a complete picture of the patient's condition.
3. A nurse is caring for a client who is being discharged home following a cerebrovascular accident. Which of the following documents should the nurse plan to include with the discharge report?
- A. List of prescribed medications
- B. Potential complications to report
- C. Family contact details
- D. Dietary restrictions
Correct answer: B
Rationale: The correct answer is B: Potential complications to report. Including potential complications in the discharge report is crucial for ensuring proper follow-up care. This information helps the client and their caregivers to be aware of warning signs that may indicate a worsening condition or the need for immediate medical attention. Choices A, C, and D are important aspects of discharge planning, but providing a list of potential complications to report takes precedence as it directly impacts the client's safety and well-being post-discharge.
4. What are the primary goals of post-operative care for a patient who has undergone abdominal surgery?
- A. Pain Management
- B. Wound Care
- C. Prevention of Complications
- D. Digestive Function
Correct answer: A
Rationale: The correct answer is A: Pain Management. After abdominal surgery, one of the primary goals of post-operative care is to manage the patient's pain effectively to ensure their comfort and promote recovery. While wound care, prevention of complications, and ensuring digestive function are also important aspects of post-operative care, pain management takes precedence as it directly impacts the patient's well-being and recovery process.
5. While caring for a client with an IV infusion who develops redness and warmth at the IV site, what is the most appropriate intervention?
- A. Elevate the IV site and apply an ice pack
- B. Administer an anti-inflammatory medication
- C. Apply a cold compress to the IV site
- D. Discontinue the IV and notify the provider
Correct answer: D
Rationale: The correct intervention when a client develops redness and warmth at the IV site, indicating phlebitis, is to discontinue the IV and notify the provider. This is crucial to prevent further complications. Elevating the IV site and applying an ice pack (Choice A) may not address the underlying issue of phlebitis. Administering an anti-inflammatory medication (Choice B) is not the primary intervention for phlebitis. Applying a cold compress (Choice C) may provide temporary relief but does not address the need to discontinue the IV when phlebitis occurs.
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