Nursing Elites

1. Which discharge instruction should the nurse teach the client diagnosed with varicose veins who has received sclerotherapy?

• A. Walk 15 to 20 minutes three (3) times a day.
• B. Keep the legs in the dependent position when sitting.
• C. Remove compression bandages before going to bed.
• D. Perform Berger-Allen exercises (4) times a day.

Correct answer: A

Rationale: The correct answer is to instruct the client to walk 15 to 20 minutes three times a day. Walking is beneficial as it helps improve circulation and reduces the risk of complications following sclerotherapy. Choice B is incorrect because keeping the legs in the dependent position when sitting can lead to increased venous pressure, worsening varicose veins. Choice C is incorrect as compression bandages should typically be worn continuously, especially during the initial healing phase. Choice D is incorrect as Berger-Allen exercises are not commonly associated with post-sclerotherapy care.

2. Which of the following is inappropriate in collecting midstream clean-catch urine specimen for urine analysis?

• A. Collect early in the morning, first voided specimen
• B. Do perineal care before specimen collection
• C. Collect 5 to 10 ml of urine
• D. Discard the first flow of urine

Correct answer: C

Rationale: The inappropriate action in collecting a midstream clean-catch urine specimen for urine analysis is to collect only 5 to 10 ml of urine. Adequate urine volume of 30 to 60 ml is required for accurate testing. Collecting a small amount like 5 to 10 ml may lead to inaccurate results due to insufficient sample size. It is crucial to follow proper collection techniques, such as discarding the first flow of urine, performing perineal care, and collecting an adequate volume, to ensure reliable test results.

3. Enteral feedings may be appropriate for patients with:

• A. Acute cholecystitis
• B. Hepatic encephalopathy
• C. Ulcerative colitis in remission
• D. Acute exacerbation of Crohn’s disease

Correct answer: D

Rationale: Enteral feedings are commonly used in patients with Crohn’s disease during acute exacerbations to provide adequate nutrition while resting the bowel. Acute cholecystitis, hepatic encephalopathy, and ulcerative colitis in remission wouldn't typically require enteral feedings as the primary nutritional support. Acute cholecystitis may necessitate fasting and intravenous fluids, hepatic encephalopathy may require dietary modifications but not enteral feedings, and patients with ulcerative colitis in remission usually have their nutritional needs met through a regular diet.

4. What are three major causes of atherosclerosis?

• A. Hyperthyroidism, underweight, and poor appetite
• B. High blood cholesterol, high blood pressure, and cigarette smoking
• C. Constipation, peptic ulcer disease, and pancreatitis
• D. Kidney failure, edema, and sodium retention

Correct answer: B

Rationale: The correct answer is B: High blood cholesterol, high blood pressure, and cigarette smoking are three major causes of atherosclerosis. Atherosclerosis is mainly attributed to the buildup of cholesterol-rich plaques in the arteries, high blood pressure causing damage to the arterial walls, and the harmful effects of cigarette smoking on blood vessels. Choices A, C, and D are incorrect because they do not directly relate to the primary causes of atherosclerosis.

5. In patients with heart failure, which type of diet is most recommended?

• A. High-sodium
• B. Low-sodium
• C. High-fat
• D. Low-carbohydrate

Correct answer: B

Rationale: In patients with heart failure, a low-sodium diet is most recommended. This type of diet helps manage fluid retention by reducing the amount of sodium in the body. Excess sodium can lead to fluid accumulation, putting additional strain on the heart. High-sodium diets can exacerbate symptoms of heart failure by causing fluid retention and increasing blood pressure. High-fat and low-carbohydrate diets are not specifically recommended for heart failure patients and may not address the underlying issues related to fluid balance and heart function.

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