Nursing Elites

1. When observing a return demonstration of a colostomy irrigation, you know that more teaching is required if pt:

• A. Lubricates the tip of the catheter prior to inserting into the stoma
• B. Hangs the irrigating bag on the bathroom door cloth hook during fluid insertion
• C. Discontinues the insertion of fluid after only 500 ml of fluid has been instilled
• D. Clamps of the flow of fluid when felling uncomfortable

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

2. What would you do to increase the amount of iron absorbed from a meal?

• A. Drink plenty of coffee before each meal
• B. Avoid eating foods rich in vitamin C with the meal
• C. Eat a calcium-rich food with the meal
• D. Consume orange juice as a beverage with a meal

Correct answer: D

Rationale: The correct answer is D: 'Consume orange juice as a beverage with a meal'. This is because Vitamin C significantly enhances the absorption of non-heme iron, a form of iron found in plant-based foods. Therefore, consuming orange juice, which is rich in vitamin C, with a meal can effectively increase iron absorption. On the contrary, choices A, B, and C are incorrect. Coffee (Choice A) contains polyphenols that can inhibit iron absorption. Avoiding vitamin C-rich foods (Choice B) would decrease iron absorption, not increase it. While calcium (Choice C) is essential for many bodily processes, it can actually inhibit iron absorption when consumed together.

3. A nurse is providing teaching to a client who has type 1 diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?

• A. Albumin in my urine is an indication of normal kidney function.
• B. I will keep my HbA1c at five percent.
• C. I will have ketones in my urine if my blood glucose is maintained at 190 milligrams per deciliter.
• D. I will keep my blood glucose levels between 200 and 212 milligrams per deciliter.

Correct answer: B

Rationale: The correct answer is B. Maintaining an HbA1c level of 5 percent indicates good long-term blood glucose control and understanding of diabetes management. Choice A is incorrect because the presence of albumin in the urine (albuminuria) is actually an indication of kidney damage in diabetes. Choice C is incorrect as ketones in the urine are a sign of inadequate insulin and can occur when blood glucose levels are high, not at a specific level like 190 mg/dL. Choice D is also incorrect as the client should aim to keep blood glucose levels within a tighter range for better control, typically between 80-130 mg/dL before meals and less than 180 mg/dL after meals.

4. A patient is admitted to the emergency room and is found to have proteinuria, a low serum albumin level, edema, and elevated blood lipids. Which condition do these symptoms typically associate with?

• A. Nephrotic syndrome
• B. Acute kidney injury
• C. Rejection of a kidney transplant
• D. Renal colic

Correct answer: A

Rationale: The correct answer is A: Nephrotic syndrome. Nephrotic syndrome is characterized by proteinuria (excess protein in urine), hypoalbuminemia (low serum albumin), edema (swelling due to fluid buildup), and hyperlipidemia (elevated blood lipids). These symptoms occur as a result of damage to the kidneys' filtering units. Acute kidney injury, rejection of a kidney transplant, and renal colic do not present with the same combination of symptoms as nephrotic syndrome. Acute kidney injury typically presents with a sudden decrease in kidney function, resulting in a build-up of waste products in the blood. Rejection of a kidney transplant may present with fever, pain at the transplant site, and changes in urine output. Renal colic usually presents with intense pain in the lower back or side, related to kidney stones.

5. What effect does the use of a hot compress have, as explained to Ronnie who has been prescribed pain medication?

• A. It produces an anesthetic effect
• B. It increases nutrition in the blood to promote wound healing
• C. It increases oxygenation to the injured tissues for better healing
• D. It induces vasoconstriction to prevent infection

Correct answer: A

Rationale: The correct answer is A: 'It produces an anesthetic effect.' Hot compresses can help alleviate pain by producing an anesthetic effect, which numbs the area. Choice B is incorrect because a hot compress does not directly increase nutrition in the blood to promote wound healing. Choice C is also incorrect because a hot compress primarily aids in pain relief rather than increasing oxygenation to the tissues for enhanced healing. Choice D is incorrect because hot compresses typically lead to vasodilation, not vasoconstriction, which aids in promoting blood flow rather than preventing infection. Safe and effective patient care relies on actions based on established nursing protocols that consider both the immediate and long-term needs of the patient.

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