Nursing Elites

1. Prior to a cardiac catheterization, what instruction should the client be reminded of?

• A. You will need to be NPO for 6 to 8 hours before the procedure.
• B. You will not be able to move around during the procedure.
• C. You will be required to lie still for several hours after the test.
• D. You will not have to drink any fluids immediately before the test.

Correct answer: A

Rationale: Being NPO (nothing by mouth) for 6 to 8 hours before a cardiac catheterization is crucial to prevent complications such as aspiration during the procedure. This helps ensure the safety and accuracy of the test results by minimizing the risk of food or liquid in the stomach interfering with the procedure. Choice B is incorrect because the client will need to lie still during the procedure to ensure its accuracy. Choice C is incorrect as the client is typically required to lie flat for a few hours after the test, not several hours. Choice D is incorrect as the client is usually not allowed to drink fluids immediately before the test to prevent complications.

2. A client in the emergency department is bleeding profusely from a gunshot wound to the abdomen. In what position should the nurse immediately place the client to promote maintenance of the client's blood pressure above a systolic pressure of 90 mm Hg?

• A. Place the client in a 45-degree Trendelenburg position to promote cerebral blood flow.
• B. Turn the client prone to apply pressure on the abdominal wound to help staunch the bleeding.
• C. Maintain the client in a supine position to reduce diaphragmatic pressure and visualize the wound.
• D. Put the client on the right side to apply pressure to the liver and spleen to stop hemorrhaging.

Correct answer: C

Rationale: In a client with profuse bleeding from a gunshot wound to the abdomen, maintaining the client in a supine position is essential to manage blood pressure. This position helps in reducing diaphragmatic pressure and allows for proper visualization of the wound, aiding in prompt assessment and intervention to control the bleeding and stabilize the client's condition. Placing the client in a 45-degree Trendelenburg position (Choice A) could worsen the bleeding by increasing intrathoracic pressure and venous return, potentially leading to further hemorrhage. Turning the client prone (Choice B) may not be feasible in this situation and can delay essential interventions. Placing the client on the right side (Choice D) does not address the immediate need to manage the bleeding and stabilize the client's condition.

3. The nurse is teaching a client about lifestyle changes to manage hypertension. Which dietary change should the nurse recommend?

• A. Increase intake of red meat
• B. Use salt substitutes liberally
• C. Limit sodium intake to 2 grams per day
• D. Increase intake of processed foods

Correct answer: C

Rationale: The correct answer is C: 'Limit sodium intake to 2 grams per day.' This recommendation is crucial in managing hypertension because excessive sodium intake can lead to elevated blood pressure. Reducing sodium intake helps the body regulate fluid balance and lower blood pressure. Choices A, B, and D are incorrect. Increasing red meat intake can worsen hypertension due to its high saturated fat content. Using salt substitutes liberally can also be harmful as they often contain high amounts of potassium, which can be problematic for individuals with certain health conditions. Increasing processed foods consumption is generally discouraged in hypertension management due to their high sodium content and low nutritional value.

4. An 81-year-old male client has emphysema. He lives at home with his cat and manages self-care with no difficulty. When making a home visit, the nurse notices that this client's tongue is somewhat cracked, and his eyeballs appear sunken into his head. Which nursing intervention is indicated?

• A. Help the client determine ways to increase his fluid intake.
• B. Obtain an appointment for the client to have an eye examination.
• C. Instruct the client to use oxygen at night and increase humidification.
• D. Schedule the client for tests to determine his sensitivity to cat hair.

Correct answer: A

Rationale: The client's cracked tongue and sunken eyes indicate dehydration. Therefore, the priority nursing intervention is to help the client determine ways to increase his fluid intake. Dehydration can exacerbate the client's emphysema symptoms and lead to further complications. Monitoring and addressing the client's fluid intake is crucial for maintaining his health and well-being. Options B, C, and D are not the immediate priorities in this situation. While an eye examination, oxygen use, and sensitivity tests are relevant aspects of care, addressing dehydration through increased fluid intake takes precedence in this scenario.

5. The healthcare provider is preparing to administer a beta blocker to a client with hypertension. What parameter should be checked before administering the medication?

• A. Serum potassium level
• B. Apical pulse
• C. Oxygen saturation
• D. Pupil reaction to light

Correct answer: B

Rationale: Before administering a beta blocker, it is crucial to check the apical pulse. Beta blockers have the potential to slow down the heart rate, making it essential to assess the pulse rate to ensure it is within the safe range before giving the medication. Checking the serum potassium level (choice A) is important when administering certain medications, but it is not specifically required before giving a beta blocker. Oxygen saturation (choice C) and pupil reaction to light (choice D) are not directly related to monitoring parameters for beta blocker administration.

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