Nursing Elites

1. Which is a characteristic that distinguishes sulfonamides from other drugs used to treat bacterial infections?

• A. Sulfonamides are bactericidal.
• B. Sulfonamides are synthetic compounds.
• C. Sulfonamides have antifungal and antiviral properties.
• D. Sulfonamides increase bacterial synthesis of folic acid.

Correct answer: B

Rationale: The characteristic that distinguishes sulfonamides from other drugs used to treat bacterial infections is that sulfonamides are synthetic compounds, not derived from biologic substances. Choice A is incorrect because sulfonamides are bacteriostatic, not bactericidal. Choice C is incorrect because sulfonamides do not have antifungal and antiviral properties. Choice D is incorrect because sulfonamides act by inhibiting bacterial synthesis of folic acid, not increasing it.

2. A client admitted from a nursing home after several recent falls needs a urine sample for culture and sensitivity. What should the nurse complete first?

• A. Obtain urine sample for culture and sensitivity.
• B. Administer intravenous antibiotics.
• C. Encourage protein intake and additional fluids.
• D. Consult physical therapy for gait training.

Correct answer: A

Rationale: In this scenario, the priority intervention is to obtain a urine sample for culture and sensitivity. Older adults with recent falls may have atypical symptoms of urinary tract infection (UTI), which can present as new-onset confusion or falling. It is crucial to rule out UTI before initiating antibiotics. While administering antibiotics, encouraging protein intake, fluids, and consulting physical therapy are important interventions, they should follow the urine sample collection to ensure accurate diagnosis and appropriate treatment.

3. The client is scheduled to begin continuous ambulatory peritoneal dialysis (CAPD). Which of the following statements by the client indicates that more teaching is required?

• A. I will need to limit my intake of protein.
• B. I can skip a dialysis session if I feel tired.
• C. I should increase my intake of potassium-rich foods.
• D. I can eat whatever I want, as long as I take my medications.

Correct answer: B

Rationale: The correct answer is B. Skipping a dialysis session can lead to serious complications as it disrupts the treatment schedule and can result in the accumulation of waste products and fluid in the body. The client must understand the importance of adhering to the prescribed dialysis regimen to maintain optimal health. Choices A, C, and D are incorrect because limiting protein intake, increasing potassium-rich foods, and taking medications do not pose the same risk as skipping dialysis sessions. These aspects are important in the management of peritoneal dialysis but do not outweigh the critical need for regular dialysis sessions to prevent complications.

4. Which clients are at risk for kidney problems? (Select all that apply.)

• A. Clients taking synthetic creatine supplements
• B. Clients taking metformin for diabetes mellitus
• C. Clients taking high-dose nonsteroidal anti-inflammatory drugs (NSAIDs) for chronic back pain
• D. Clients taking prenatal vitamins and using albuterol nebulizers

Correct answer: A

Rationale: Clients who take synthetic creatine supplements, metformin, and high-dose or long-term NSAIDs are at risk for kidney dysfunction. Synthetic creatine supplements can cause kidney damage, metformin may rarely cause lactic acidosis leading to renal impairment, and high-dose NSAIDs can lead to acute kidney injury. Prenatal vitamins and albuterol nebulizers are not known to significantly impact kidney function, thus do not pose a risk for kidney problems.

5. A nurse cares for a client with urinary incontinence. The client states, “I am so embarrassed. My bladder leaks like a young child’s bladder.” How should the nurse respond?

• A. I understand how you feel. I would be mortified.
• B. Incontinence pads will minimize leaks in public.
• C. I can teach you strategies to help control your incontinence.
• D. More women experience incontinence than you might think.

Correct answer: C

Rationale: The nurse should accept and acknowledge the client’s concerns, and assist the client to learn techniques that will allow control of urinary incontinence. The nurse should not diminish the client’s concerns with the use of pads or stating statistics about the occurrence of incontinence.

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