Nursing Elites

1. Which of the following conditions may necessitate fluid restriction?

• A. Fever
• B. Chronic Obstructive Pulmonary Disease
• C. Renal Failure
• D. Dehydration

Correct answer: C

Rationale: Renal failure often necessitates fluid restriction to prevent fluid overload. In renal failure, the kidneys are unable to effectively filter and excrete excess fluids, leading to fluid accumulation in the body. Restricting fluid intake helps manage this condition by preventing further fluid buildup and complications such as edema and electrolyte imbalances.

2. A patient is kept off food and fluids for 10 hours before surgery. His oral temperature at 8 a.m. is 99.8°F (37.7°C). This temperature reading probably indicates:

• A. Infection
• B. Hypothermia
• C. Anxiety
• D. Dehydration

Correct answer: D

Rationale: A patient being kept off food and fluids before surgery can lead to dehydration. Dehydration can cause a slight increase in body temperature, which could explain the elevated oral temperature reading of 99.8°F (37.7°C) in this scenario. Infections are more likely to cause higher fevers, hypothermia would present with a lower temperature, and anxiety typically does not directly affect body temperature in this manner.

3. A client has had a cast applied, and a nurse is providing care. Which of the following actions should the nurse take first?

• A. Place an ice pack over the cast.
• B. Palpate the pulse distal to the cast.
• C. Teach the client to keep the cast clean and dry.
• D. Position the casted extremity on a pillow.

Correct answer: B

Rationale: When caring for a client with a newly applied cast, the nurse's priority should be to assess the circulation by palpating the pulse distal to the cast. This is crucial to ensure there is no compromise in blood flow, which could lead to serious complications. Placing an ice pack over the cast, teaching the client about cast care, and positioning the casted extremity on a pillow are important interventions but should follow the assessment of circulation.

4. A healthcare professional is preparing to administer a dose of a new prescription of prednisone to a client who has COPD. The healthcare professional should not concentrate on which of the following adverse effects of this medication?

• A. Hypokalemia
• B. Tachycardia
• C. Fluid retention
• D. Black, tarry stools

Correct answer: B

Rationale: When administering prednisone, a corticosteroid medication, to a client with COPD, the healthcare professional should be aware of potential adverse effects. Tachycardia is not a common adverse effect of prednisone use. The correct adverse effects to monitor for include hypokalemia, fluid retention, and gastrointestinal issues like black, tarry stools due to potential gastrointestinal bleeding. Therefore, the healthcare professional should not concentrate on tachycardia but should focus on the other listed adverse effects when administering prednisone to a client with COPD.

5. For a rectal examination, the patient can be directed to assume which of the following positions?

• A. Genupectoral
• B. Sims
• C. Horizontal recumbent
• D. All of the above

Correct answer: B

Rationale: The correct position for a rectal examination is the Sims position, where the patient lies on their left side with the upper knee flexed. This position allows for easy access and visualization of the rectal area for examination.

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