Nursing Elites

1. What is the best way to monitor fluid balance in a patient with kidney disease?

• A. Monitor daily weight
• B. Monitor input and output
• C. Check for edema
• D. Check urine output

Correct answer: A

Rationale: The correct answer is to monitor daily weight. This method is the most accurate way to assess fluid balance in patients with kidney disease. Daily weight monitoring can detect even small changes in fluid balance, such as fluid retention or loss, which may not be evident through other methods. Monitoring input and output (choice B) is also important but may not provide a complete picture of fluid balance as it doesn't consider factors like insensible losses. Checking for edema (choice C) is a sign of fluid retention but may not always be present or may be difficult to assess accurately. Checking urine output (choice D) is important but may not reflect the overall fluid balance status of the patient.

2. A client with a colostomy needs optimal skin integrity. What action should the nurse take to promote this?

• A. Cleanse the peristomal skin with alcohol.
• B. Change the colostomy pouch every 3 days.
• C. Use a barrier cream to protect the skin from the pouch contents.
• D. Cleanse the stoma with hydrogen peroxide.

Correct answer: C

Rationale: To promote optimal skin integrity in a client with a colostomy, using a barrier cream to protect the skin from the irritating effects of the colostomy pouch contents is essential. Cleansing the peristomal skin with alcohol (Choice A) can be too harsh and drying for the skin. Changing the colostomy pouch every 3 days (Choice B) is important for hygiene but using a barrier cream is more directly related to skin protection. Cleaning the stoma with hydrogen peroxide (Choice D) is not recommended as it can be too abrasive for the sensitive stoma area.

3. A group of newly licensed nurses is being taught about client advocacy by a nurse. Which of the following statements by a newly licensed nurse indicates an understanding of the teaching?

• A. I will intervene if there is a conflict between a client and their provider.
• B. I should not advocate for a client unless they are able to ask me themselves.
• C. I will inform a client that their family should help make their health care decisions.
• D. I believe the best health care decision is for the provider to decide.

Correct answer: B

Rationale: The correct answer is B because advocating for a client should not be dependent on the client's ability to ask for it personally. Advocacy is crucial to ensure clients' rights are upheld, especially when they are unable to express their wishes. Choice A is incorrect as intervening in a conflict may not always be advocating for the client's best interests. Choice C is incorrect because the family should not make health care decisions for the client without their input. Choice D is incorrect as it disregards the importance of client autonomy and involvement in decision-making.

4. A client who is 1 day postpartum plans to breastfeed. Which statement indicates an understanding of the teaching provided by the nurse?

• A. I will breastfeed every 4 hours.
• B. I will feed my baby from each breast for 5 minutes.
• C. I will use both breasts at each feeding.
• D. I will pump my breasts if my baby does not wake up to feed.

Correct answer: C

Rationale: The correct answer is C. Using both breasts at each feeding helps ensure adequate milk production and consumption. Option A is incorrect because breastfeeding should be done on demand rather than following a strict schedule. Option B is incorrect as limiting feeding time to 5 minutes per breast may not provide the baby with enough milk. Option D is also incorrect as pumping should not replace direct breastfeeding unless there is a specific medical reason to do so.

5. A nurse in a provider's office is reviewing the laboratory results of a group of clients. Which of the following sexually transmitted infections is a nationally notifiable infectious disease that should be reported to the state health department?

• A. Chlamydia
• B. Human papillomavirus
• C. Candidiasis
• D. Herpes simplex virus

Correct answer: A

Rationale: Chlamydia is the correct answer. Chlamydia is a sexually transmitted infection that is considered a nationally notifiable infectious disease, meaning healthcare providers are required to report cases to public health authorities. Reporting such cases is crucial for disease surveillance and implementing appropriate control measures. Human papillomavirus, Candidiasis, and Herpes simplex virus are not nationally notifiable infectious diseases and do not require mandatory reporting to the state health department.

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