Nursing Elites

1. When inserting an indwelling urinary catheter in a female client and urine flows into the tubing, what is the next action?

• A. Document the color and clarity of the urine
• B. Insert the catheter an additional inch
• C. Ask the client to breathe deeply and slowly exhale
• D. Inflate the balloon with 5 mL of sterile water

Correct answer: D

Rationale: When urine flows into the tubing during the insertion of an indwelling urinary catheter, it confirms proper catheter placement. The next step should be to inflate the balloon with the specified amount of sterile water to secure the catheter in place. Documenting the color and clarity of the urine (choice A) is important for assessment but not the immediate next action. Inserting the catheter further (choice B) without securing it could cause harm. Asking the client to breathe deeply (choice C) is not relevant to this situation.

2. During a community health fair, a nurse is providing education on the effects of smoking. What is the most important information to include?

• A. Smoking can lead to cosmetic issues like tooth staining.
• B. Smoking is a leading cause of preventable death worldwide.
• C. Smoking temporarily elevates mood and alertness.
• D. Smoking is an expensive habit.

Correct answer: B

Rationale: The correct answer is B: 'Smoking is a leading cause of preventable death worldwide.' This information is crucial as it highlights the severe health risks associated with smoking, emphasizing the importance of cessation for overall health. Choice A is incorrect because cosmetic issues like tooth staining are not as significant as the life-threatening consequences of smoking. Choice C is incorrect because although smoking may temporarily elevate mood and alertness due to nicotine, this does not outweigh the serious health implications. Choice D is incorrect as while smoking is indeed an expensive habit, the focus should be on the health-related consequences to stress the urgency of quitting.

3. Before a client undergoes a Magnetic Resonance Imaging (MRI) scan with contrast, what should the nurse assess?

• A. If the client has any metal implants
• B. If the client has allergies to iodine or shellfish
• C. If the client has a history of claustrophobia
• D. If the client has ever had a similar procedure before

Correct answer: A

Rationale: Before an MRI scan with contrast, the nurse should assess if the client has any metal implants. Metal implants can interfere with the magnetic field of the MRI, which can pose a risk to the client's safety and compromise the quality of the scan. Assessing for allergies to iodine or shellfish (Choice B) is important for contrast agents but not specific to metal implants. Claustrophobia assessment (Choice C) is relevant for MRI scans due to the confined space but not specific to metal implants. Past procedures (Choice D) are important for comparison but not directly related to the risks associated with metal implants during an MRI scan with contrast.

4. After receiving a report, the nurse receives the laboratory values for four clients. Which client requires the nurse’s immediate intervention? The client who is...

• A. Short of breath after a shower and has a hemoglobin of 8 grams
• B. Bleeding from a finger stick and has a prothrombin time of 30 seconds
• C. Febrile and has a WBC count of 14,000/mm3
• D. Trembling and has a glucose level of 50 mg/dL

Correct answer: D

Rationale: A glucose level of 50 mg/dL is indicative of hypoglycemia, which requires immediate intervention to prevent further complications. Hypoglycemia can lead to serious consequences such as altered mental status, seizures, and even coma if not promptly addressed. The other options do not present immediate life-threatening conditions that require urgent intervention. Shortness of breath with a hemoglobin of 8 grams may indicate anemia but does not require immediate intervention. Bleeding from a finger stick with a prothrombin time of 30 seconds may suggest clotting issues, which are important but not as immediately critical as hypoglycemia. Being febrile with an elevated WBC count could indicate infection, which is concerning but not as urgently critical as hypoglycemia.

5. The healthcare provider is providing discharge instructions to a client with chronic heart failure. Which dietary recommendation is most appropriate?

• A. Increase fluid intake.
• B. Follow a low-sodium diet.
• C. Follow a high-protein diet.
• D. Increase sodium intake.

Correct answer: B

Rationale: The most appropriate dietary recommendation for a client with chronic heart failure is to follow a low-sodium diet. This helps manage the condition by reducing fluid retention and the workload on the heart. High fluid intake can lead to fluid overload and exacerbate heart failure symptoms. While protein is important for overall health, a high-protein diet is not specifically indicated for chronic heart failure. Increasing sodium intake is contraindicated in heart failure as it can worsen fluid retention and increase the workload on the heart.

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