Nursing Elites

1. In a routine sputum analysis, which of the following indicates proper nursing action before sputum collection?

• A. Secure a clean container
• B. Discard the container if the outside becomes dirty
• C. Rinse the client's mouth with Listerine before collection
• D. Tell the client that 4 tablespoons of sputum are needed

Correct answer: A

Rationale: The correct answer is to secure a clean container before sputum collection. This is essential to prevent contamination of the specimen, ensuring accurate test results and avoiding the introduction of external particles or bacteria. Choice B is incorrect because discarding the container if the outside becomes dirty is not necessary; the cleanliness of the inside is crucial. Choice C is incorrect as rinsing the client's mouth with Listerine before collection may introduce unwanted substances that can affect the test results. Choice D is incorrect as the amount of sputum required can vary depending on the test, and specifying a specific amount without medical guidance is not appropriate.

2. Patients with gallbladder disease should reduce their intake of:

• A. Protein
• B. Sodium
• C. Cholesterol
• D. Fat

Correct answer: D

Rationale: Patients with gallbladder disease are advised to reduce their fat intake because fats can trigger gallbladder symptoms such as pain and bloating. While protein, sodium, and cholesterol may also impact overall health, reducing fat intake specifically helps manage gallbladder-related symptoms effectively. Protein is important for tissue repair, sodium can affect blood pressure, and cholesterol levels impact heart health, but in the context of gallbladder disease, fat reduction is the most beneficial.

3. The nurse is caring for the client one day postoperative sigmoid colostomy operation. Which independent nursing intervention should the nurse implement?

• A. Change the infusion rate of the intravenous fluid
• B. Encourage the client to discuss his or her feelings
• C. Administer opioid narcotic medications for pain management
• D. Assist the client out of bed to sit in the chair twice daily

Correct answer: D

Rationale: Assisting the client to sit in a chair is an essential nursing intervention postoperatively as it helps promote circulation, prevent complications like blood clots, and aids in the recovery process. Changing the infusion rate of intravenous fluid (Choice A) requires a physician's order and is not an independent nursing intervention. Encouraging the client to discuss feelings (Choice B) is important for emotional support but not as crucial as physical care immediately postoperatively. Administering opioid narcotic medications (Choice C) for pain management should be based on a prescribed schedule and assessment rather than being an independent nursing action.

4. Whenever possible, patients evacuated from the theater of operations who are expected to return within 60 days are admitted to which of the following?

• A. Civilian hospitals participating in the National Disaster Medical System
• B. DOD tri-service hospitals
• C. Department of Veterans Affairs hospitals
• D. Field hospitals

Correct answer: B

Rationale: Patients evacuated from the theater of operations who are expected to return within 60 days are admitted to DOD tri-service hospitals. These hospitals are equipped to provide specialized care tailored to military personnel. Choice A, civilian hospitals participating in the National Disaster Medical System, may not always have the necessary expertise and resources to cater specifically to military-related injuries. Choice C, Department of Veterans Affairs hospitals, primarily serve veterans and may not always accommodate short-term care for active-duty personnel. Choice D, field hospitals, are usually set up in temporary or emergency situations and are not designed for long-term care, making them less suitable for patients expected to return within 60 days.

5. A family came to the emergency department with complaints of food poisoning. Which client should the nurse see first?

• A. 32-year-old with diarrhea for 6 hours
• B. 2-year-old with 1 wet diaper in 24 hours
• C. 40-year-old with abdominal cramping
• D. 10-year-old who is nauseated

Correct answer: B

Rationale: In cases of food poisoning, a 2-year-old with reduced urine output is a critical finding indicating dehydration, requiring immediate attention to prevent complications. The reduced urine output is a sign of decreased fluid intake or increased fluid loss, putting the child at high risk for dehydration. This client should be seen first to assess hydration status, initiate necessary interventions, and prevent further complications. While the other symptoms presented by the other clients are concerning, the 2-year-old's decreased urine output poses the most immediate threat to their well-being.

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