Nursing Elites

1. Which of the following is a common cause of acute kidney injury?

• A. Hypertension
• B. Dehydration
• C. Infection
• D. Hypotension

Correct answer: C

Rationale: Infection is a common cause of acute kidney injury because when the body fights an infection, it activates the immune response, leading to inflammation. This inflammatory response can affect the kidneys and impair their function. While hypertension (choice A) is a risk factor for chronic kidney disease, it is not a direct cause of acute kidney injury. Dehydration (choice B) can lead to prerenal acute kidney injury due to decreased blood flow to the kidneys, but infection is a more common cause of acute kidney injury. Hypotension (choice D) can contribute to prerenal acute kidney injury, but it is not a direct cause like infection.

2. A client is being taught about self-catheterization in the home setting. Which statements should the nurse include in this client’s teaching? (Select all that apply.)

• A. Wash your hands before and after self-catheterization.
• B. Use lubricant on the tip of the catheter before insertion.
• C. A & B
• D. Self-catheterize at least twice a day or every 12 hours.

Correct answer: C

Rationale: In teaching a client about self-catheterization, it is essential to emphasize proper hand hygiene before and after the procedure to prevent infections. Using lubricant on the catheter helps with insertion and reduces discomfort. Therefore, statements A and B are correct and should be included in the client's teaching. Option D is incorrect because self-catheterization frequency should be individualized based on the client's needs, and a specific time frame like every 12 hours may not be suitable for everyone. Choosing a smaller lumen catheter is preferred over a larger one. Self-catheterization should not be limited to a specific time frame but should be based on the individual's needs and voiding patterns. Therefore, option C is the correct choice as it includes the two essential statements for teaching self-catheterization in the home setting.

3. A client presents with a urine specific gravity of 1.018. What action should the nurse take?

• A. Evaluate the client’s intake and output for the past 24 hours.
• B. Document the finding in the chart and continue to monitor.
• C. Obtain a specimen for a urine culture and sensitivity.
• D. Encourage the client to drink more fluids, especially water.

Correct answer: B

Rationale: A urine specific gravity of 1.018 falls within the normal range, indicating adequate hydration. Therefore, the appropriate action is to document this finding in the client's chart and continue monitoring. There is no need to evaluate intake and output, as the specific gravity is normal. Obtaining a urine culture and sensitivity or encouraging increased fluid intake is unnecessary in this situation.

4. A nurse assesses clients on the medical-surgical unit. Which client is at greatest risk for bladder cancer?

• A. A 25-year-old female with a history of sexually transmitted diseases
• B. A 42-year-old male who has worked in a lumber yard for 10 years
• C. A 55-year-old female who has had numerous episodes of bacterial cystitis
• D. An 86-year-old male with a 50–pack-year cigarette smoking history

Correct answer: D

Rationale: The correct answer is D. The greatest risk factor for bladder cancer is a long history of tobacco use, which is reflected in an 86-year-old male with a 50–pack-year cigarette smoking history. Smoking is a well-established risk factor for developing bladder cancer. Choices A, B, and C are not directly linked to an increased risk of bladder cancer. While sexually transmitted diseases, certain occupational exposures, and recurrent urinary tract infections may pose other health risks, they are not specifically associated with an elevated risk of bladder cancer.

5. A client with heart disease is on a continuous telemetry monitor and has developed sinus bradycardia. In determining the possible cause of the bradycardia, the nurse assesses the client's medication record. Which medication is most likely the cause of the bradycardia?

• A. Propranolol (Inderal).
• B. Captopril (Capoten).
• C. Furosemide (Lasix).
• D. Dobutamine (Dobutrex).

Correct answer: A

Rationale: Propranolol (Inderal) is a beta-adrenergic blocking agent that acts to decrease heart rate and contractility. Sinus bradycardia is a common side effect of beta blockers due to their negative chronotropic effect on the heart. Captopril (Capoten) is an ACE inhibitor used for hypertension and heart failure, not associated with causing bradycardia. Furosemide (Lasix) is a loop diuretic that can lead to electrolyte imbalances but not commonly linked to bradycardia. Dobutamine (Dobutrex) is a beta-1 adrenergic agonist that increases heart rate and contractility, making it an unlikely cause of bradycardia in this scenario.

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