Nursing Elites

1. A client has had a pulmonary artery catheter inserted. In performing hemodynamic monitoring with the catheter, the nurse will wedge the catheter to gain information about which of the following?

• A. Cardiac output.
• B. Right atrial blood flow.
• C. Left end-diastolic pressure.
• D. Cardiac index.

Correct answer: C

Rationale: The correct answer is C: Left end-diastolic pressure. Wedging the pulmonary artery catheter allows the nurse to obtain the pulmonary artery wedge pressure, which reflects the left end-diastolic pressure. This pressure is essential in assessing left ventricular function and diagnosing conditions like heart failure. Choices A, B, and D are incorrect because wedging the catheter does not directly provide information about cardiac output, right atrial blood flow, or cardiac index.

2. A client recovering from a urologic procedure is being assessed by a nurse. Which assessment finding indicates an obstruction of urine flow?

• A. Severe pain
• B. Overflow incontinence
• C. Hypotension
• D. Blood-tinged urine

Correct answer: B

Rationale: The correct answer is 'B: Overflow incontinence.' The most common manifestation of urethral stricture after a urologic procedure is obstruction of urine flow. This obstruction can lead to overflow incontinence, which is the involuntary loss of urine when the bladder is distended. Severe pain is not typically associated with an obstruction of urine flow. Hypotension is unrelated to this issue. Blood-tinged urine is not a direct indication of an obstruction of urine flow but may indicate other conditions like trauma or infection.

3. A client is scheduled to have an arteriogram. During the arteriogram, the client reports having nausea, tingling, and dyspnea. The nurse's immediate action should be to:

• A. Administer epinephrine.
• B. Inform the physician.
• C. Administer oxygen.
• D. Inform the client that the procedure is almost over.

Correct answer: B

Rationale: The correct immediate action for the nurse to take in this situation is to inform the physician. The symptoms described - nausea, tingling, and dyspnea - indicate a potential allergic reaction to the contrast dye used in the arteriogram. It is crucial to notify the physician promptly so that further assessment and appropriate interventions can be initiated. Administering epinephrine without physician guidance can be dangerous as the physician needs to evaluate the severity of the reaction and determine the necessary treatment. Administering oxygen may be needed but should be done under the physician's direction. Informing the client that the procedure is almost over is not a priority when the client is experiencing symptoms of a possible allergic reaction.

4. A client with chronic renal failure is prescribed a low-protein diet. The nurse should explain to the client that the purpose of this diet is to:

• A. Prevent fluid overload.
• B. Reduce the workload on the kidneys.
• C. Prevent dehydration.
• D. Maintain electrolyte balance.

Correct answer: B

Rationale: The correct answer is B: 'Reduce the workload on the kidneys.' A low-protein diet is prescribed for clients with chronic renal failure to decrease the production of urea and other nitrogenous wastes, which can accumulate in the body when the kidneys are not functioning properly. This reduction in protein intake helps to lessen the burden on the kidneys, as they may have difficulty in filtering and excreting waste products. Choice A is incorrect because fluid overload is more related to restrictions in fluid intake rather than protein intake. Choice C is incorrect as a low-protein diet does not directly prevent dehydration. Choice D is incorrect because while electrolyte balance is essential in renal failure, the primary purpose of a low-protein diet is to reduce the workload on the kidneys by limiting the production of waste products.

5. The client is being taught about the best time to plan sexual intercourse in order to conceive. Which information should be provided?

• A. Two weeks before menstruation.
• B. Vaginal mucous discharge is thick.
• C. Low basal temperature.
• D. First thing in the morning.

Correct answer: A

Rationale: The correct answer is A: 'Two weeks before menstruation.' Ovulation typically occurs 14 days before menstruation begins during a typical 28-day cycle. To increase the chances of conception, sexual intercourse should occur within 24 hours of ovulation. High estrogen levels during ovulation lead to changes in vaginal mucous discharge, making it more 'slippery' and stretchy. Basal temperature rises during ovulation. The timing of intercourse during the day is less significant than ensuring it happens around ovulation. The other options are incorrect because planning intercourse two weeks before menstruation is likely to miss the fertile window, thick vaginal mucous discharge indicates ovulation is approaching, and low basal temperature is not indicative of the fertile period.

Similar Questions