Nursing Elites

1. What teaching should be provided to a patient following surgical removal of a cataract?

• A. Avoid NSAIDs
• B. Wear dark glasses while outdoors
• C. Creamy white drainage is normal
• D. Reduce phosphorus intake to 700 mg/day

Correct answer: A

Rationale: The correct teaching to provide to a patient following surgical removal of a cataract is to avoid NSAIDs. NSAIDs can increase the risk of bleeding at the surgical site, so it is important to steer clear of them. Choice B, wearing dark glasses while outdoors, may be recommended post-surgery to protect the eyes from bright light, but it is not the priority teaching in this case. Choice C, stating that creamy white drainage is normal, is not accurate as drainage from the eye should be monitored and reported. Choice D, reducing phosphorus intake to 700 mg/day, is unrelated to post-cataract surgery care and is not a necessary teaching point.

2. What should be monitored in a patient with diabetes insipidus?

• A. Monitor urine specific gravity for values below 1.005
• B. Monitor for increased thirst
• C. Monitor serum albumin levels
• D. Monitor blood pressure closely

Correct answer: A

Rationale: In a patient with diabetes insipidus, monitoring urine specific gravity for values below 1.005 is crucial. Low urine specific gravity indicates excessive water loss, a key characteristic of diabetes insipidus. Monitoring for increased thirst (choice B) may be a symptom presented by the patient, but it does not directly reflect the condition's severity. Monitoring serum albumin levels (choice C) is not typically associated with diabetes insipidus. Monitoring blood pressure closely (choice D) is not a primary concern in diabetes insipidus unless severe dehydration leads to hypotension.

3. What is the priority intervention when continuous bubbling is observed in the water seal chamber of a chest tube?

• A. Check for an air leak
• B. Continue monitoring as it is not normal
• C. Replace the chest tube system
• D. Tighten the tube connections

Correct answer: A

Rationale: The correct answer is to 'Check for an air leak.' Continuous bubbling in the water seal chamber of a chest tube indicates an air leak, which can compromise the effectiveness of the chest tube in re-expanding the lung. Checking for an air leak is crucial to prevent respiratory complications. Choice B is incorrect because continuous bubbling is not normal and requires immediate intervention to address the air leak. Choice C is incorrect as replacing the entire chest tube system is not the initial priority when an air leak is suspected. Choice D is incorrect because tightening tube connections may not address the underlying issue of an air leak and should not be the initial action taken in this situation.

4. What is the first medication to administer to a patient experiencing wheezing due to an allergic reaction?

• A. Albuterol via nebulizer
• B. Methylprednisolone 100 mg IV
• C. Cromolyn 20 mg via nebulizer
• D. Aminophylline 500 mg IV

Correct answer: A

Rationale: The correct answer is A, Albuterol via nebulizer. Albuterol is the first-choice medication for wheezing due to its fast-acting bronchodilatory effect, which helps in relieving the symptoms quickly. Choice B, Methylprednisolone 100 mg IV, is a corticosteroid used for its anti-inflammatory effects and would be beneficial in reducing inflammation in allergic reactions but is not the first-line treatment for wheezing. Choice C, Cromolyn 20 mg via nebulizer, is a mast cell stabilizer used to prevent asthma attacks but is not the immediate treatment for wheezing during an allergic reaction. Choice D, Aminophylline 500 mg IV, is a bronchodilator but is not typically the initial medication of choice for wheezing in an allergic reaction.

5. What recommendations should the nurse provide to a patient diagnosed with GERD?

• A. Avoid items like mint that increase gastric acid secretion
• B. Eat small, frequent meals
• C. Avoid eating 1 hour before bedtime
• D. Avoid black and red pepper

Correct answer: A

Rationale: The correct answer is A: 'Avoid items like mint that increase gastric acid secretion.' Mint can relax the lower esophageal sphincter, leading to increased gastric acid secretion and worsening GERD symptoms. Choice B is a good recommendation for GERD management as it helps prevent excessive stomach distension. Choice C is also a recommended practice to avoid reflux during sleep. Choice D, avoiding black and red pepper, is not directly linked to exacerbating GERD symptoms, so it is not the most relevant recommendation for a patient diagnosed with GERD.

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