Nursing Elites

1. Which of the following is classified as a prerenal condition that affects urinary elimination?

• A. Nephrotoxic medications
• B. Pericardial tamponade
• C. Neurogenic bladder
• D. Polycystic kidney disease

Correct answer: B

Rationale: A prerenal condition is one that causes reduced urinary elimination by affecting the blood flow to the kidneys. Pericardial tamponade is a condition that impacts the heart's ability to pump sufficient blood, leading to decreased blood flow to vital organs such as the kidneys. This reduction in blood flow to the kidneys can result in decreased urine production. The other choices, such as nephrotoxic medications, neurogenic bladder, and polycystic kidney disease, do not primarily affect the blood flow to the kidneys and are not classified as prerenal conditions that impact urinary elimination.

2. What is the correct action regarding thigh pressure when comparing it to arm pressure in an adolescent with high blood pressure?

• A. The popliteal artery should be auscultated to obtain thigh pressure.
• B. The best position to measure thigh pressure is the prone position.
• C. If the blood pressure in the arm is high in an adolescent, then it should be compared with the thigh pressure.
• D. Thigh pressure is generally higher than arm pressure due to the proximity to the heart and the size of the popliteal vessels.

Correct answer: C

Rationale: When blood pressure measured in the arm is significantly elevated, especially in adolescents and young adults, it is crucial to compare it with thigh pressure to assess for coarctation of the aorta. The popliteal artery, not the femoral artery, should be auscultated for the thigh pressure reading as the femoral artery is closer to the placement of the blood pressure cuff. Generally, thigh pressure is higher than arm pressure; however, if there is coarctation of the artery, arm pressures can be higher than thigh pressures. The preferred position for measuring thigh pressure is the prone position, not supine, with the knee slightly bent to facilitate accurate readings.

3. Which of the following diseases would require the nurse to wear an N95 respirator as part of personal protective equipment?

• A. Human immunodeficiency virus
• B. Clostridium difficile enterocolitis
• C. Vancomycin-resistant enterococcus
• D. Measles

Correct answer: D

Rationale: Infections that require airborne precautions necessitate the use of an N95 respirator, a type of mask that filters particles that are 5 micrograms or smaller. Illnesses that require airborne precautions include Measles, Varicella, Severe Acute Respiratory Syndrome (SARS), and tuberculosis. Measles is a highly contagious airborne disease caused by a virus. It can spread through respiratory droplets when an infected person coughs or sneezes. Wearing an N95 respirator helps prevent the nurse from inhaling these infectious particles. Human immunodeficiency virus, Clostridium difficile enterocolitis, and Vancomycin-resistant enterococcus do not require the use of an N95 respirator as they are not transmitted through the air but have other modes of transmission.

4. While caring for Mrs. Thomas, you see a notation on the nursing care plan that states 'ambulate at least 10 yards qid'. This patient will be assisted with ambulation at which of the following times?

• A. 10:00 AM
• B. 10 am and 2 pm
• C. 10 am and 2 pm
• D. 10 am, 2 pm, 6 pm, and 10 pm

Correct answer: D

Rationale: The correct answer is to assist the patient with ambulation at 10 am, 2 pm, 6 pm, and 10 pm as qid stands for four times per day. This schedule is commonly followed in healthcare facilities to ensure regular ambulation and exercise for the patient. Choices A, B, and C do not cover all the specified times for ambulation as indicated by the qid notation on the care plan.

5. Specific gravity in urinalysis:

• A. compares the concentration of urine to that of distilled water
• B. is useless when the patient is dehydrated
• C. can only be measured using a refractometer
• D. None of the above

Correct answer: A

Rationale: Specific gravity in urinalysis measures the concentration of solutes in urine compared to that of distilled water. This comparison helps in assessing the kidney's ability to concentrate urine properly. It is a valuable test even in dehydrated patients as it provides insights into renal function. Specific gravity can be measured using various methods, including a refractometer or reagent strips. Normal specific gravity readings of human urine typically range from 1.005 to 1.030. Choice A is correct as it accurately describes the purpose of specific gravity in urinalysis. Choices B and C are incorrect as specific gravity remains relevant in dehydrated patients and can be measured using different techniques, not solely a refractometer.

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