Nursing Elites

1. Which of the following sets of word parts means 'Pain'?

• A. dynia and -algia
• B. a- and an
• C. ia and -ac
• D. pathy and -osis

Correct answer: A

Rationale: The correct answer is 'dynia and -algia.' The word parts 'dynia' and '-algia' specifically relate to pain. 'Dynia' refers to pain, and '-algia' also denotes pain. Therefore, when combined, they form the meaning 'pain.' Choices B, C, and D are incorrect because 'a-' and 'an' do not relate to pain, 'ia' and '-ac' do not specifically convey pain, and 'pathy' and '-osis' are not word parts that directly signify pain.

2. What procedure examines a portion of the large intestine with an endoscope?

• A. Colposcopy
• B. Sigmoidoscopy
• C. Upper GI
• D. Cardiac catheterization

Correct answer: B

Rationale: Sigmoidoscopy is the correct answer because it specifically examines the sigmoid colon located in the descending colon using an endoscope inserted through the rectum. This procedure captures video and images of the large intestine's lining, helping in the diagnosis of conditions like inflammatory bowel disease or colorectal cancer. Colposcopy, on the other hand, is a procedure for examining the cervix and vagina, not the large intestine. Upper GI involves capturing images of the esophagus and stomach, focusing on the upper gastrointestinal tract, not the large intestine. Cardiac catheterization is a procedure that involves threading a thin instrument through the femoral artery to the heart, used for cardiac interventions and not related to examining the large intestine.

3. Which of the following actions is most appropriate for reducing the risk of infection during the post-operative period?

• A. Flush the central line with heparin at least every four hours
• B. Administer narcotic analgesics as needed
• C. Remove the urinary catheter as soon as the client is ambulatory
• D. Order a high-protein diet for the client

Correct answer: C

Rationale: The most appropriate action to reduce the risk of infection during the post-operative period is to remove the urinary catheter as soon as the client is ambulatory. Urinary catheters can serve as a source of bacteria, increasing the risk of infection in the bladder or urethra. By removing the catheter promptly once the client is mobile, the risk of infection can be minimized. Option A, flushing the central line with heparin, is not directly related to reducing urinary tract infections. Option B, administering narcotic analgesics as needed, is important for pain management but does not directly address infection prevention. Option D, ordering a high-protein diet, may be beneficial for wound healing but does not specifically target infection risk reduction in the post-operative period.

4. A client is taking a walk down the hallway when she suddenly realizes that she needs to use the restroom. Although she tries to make it to the bathroom on time, she is incontinent of urine before reaching the toilet. What type of incontinence does this situation represent?

• A. Relex incontinence
• B. Urge incontinence
• C. Total incontinence
• D. Functional incontinence

Correct answer: D

Rationale: Functional incontinence occurs when a client develops an urge to void but may not be able to reach the toilet in time. In this scenario, the client had the urge to use the restroom but was unable to make it in time, leading to incontinence. Functional incontinence may be related to conditions that cause the client to forget bladder sensation until the last minute, such as cognitive changes, or the client may have mobility problems that prevent her from reaching the bathroom in time. Choice A, Reflex incontinence, is incorrect as reflex incontinence is characterized by the involuntary loss of urine due to hyperreflexia of the detrusor muscle. Choice B, Urge incontinence, is not the correct answer as urge incontinence is the involuntary loss of urine associated with a strong desire to void. Choice C, Total incontinence, is also incorrect as it refers to the continuous and unpredictable loss of urine, not specifically related to the inability to reach the toilet in time.

5. After change-of-shift report, which patient should the nurse assess first?

• A. 72-year-old with cor pulmonale who has 4+ bilateral edema in his legs and feet
• B. 28-year-old with a history of a lung transplant and a temperature of 101 F (38.3 C)
• C. 40-year-old with a pleural effusion who is complaining of severe stabbing chest pain
• D. 64-year-old with lung cancer and tracheal deviation after subclavian catheter insertion

Correct answer: D

Rationale: The patient with lung cancer and tracheal deviation after a subclavian catheter insertion should be assessed first. Tracheal deviation can indicate tension pneumothorax, a life-threatening condition that requires immediate intervention to prevent inadequate cardiac output or hypoxemia. While the other patients also need assessment, the potential for tension pneumothorax in the patient with tracheal deviation necessitates urgent attention to prevent complications.

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