Nursing Elites

1. A client is scheduled for a colonoscopy. Which instruction should the nurse provide?

• A. Eat a light breakfast on the day of the procedure.
• B. You will need to drink a bowel preparation solution before the procedure.
• C. Avoid all liquids for 24 hours before the procedure.
• D. You can continue taking your blood thinners until the day of the procedure.

Correct answer: B

Rationale: The correct instruction for a client scheduled for a colonoscopy is to drink a bowel preparation solution before the procedure. This solution helps cleanse the colon, ensuring clear visualization during the colonoscopy procedure. Choice A is incorrect because a light breakfast is usually recommended the day before the procedure, not on the day of the colonoscopy. Choice C is incorrect as it is important to stay hydrated and follow specific instructions regarding liquid intake. Choice D is incorrect as blood thinners may need to be adjusted or stopped before the colonoscopy to reduce the risk of bleeding during the procedure.

2. The nurse is planning care for a 16-year-old with juvenile rheumatoid arthritis (JRA). The nurse includes activities to strengthen and mobilize the joints and surrounding muscles. Which physical therapy regimen should the nurse encourage the adolescent to implement?

• A. Exercise in a swimming pool.
• B. Splint affected joints during activity.
• C. Perform passive range of motion exercises twice daily.
• D. Begin a training program of lifting weights and running.

Correct answer: A

Rationale: Exercising in a swimming pool is beneficial for adolescents with juvenile rheumatoid arthritis as it reduces stress on the joints while allowing movement and strengthening. The buoyancy of water supports the body, making exercises easier and less painful, while also providing resistance to strengthen muscles. This form of exercise can help improve joint mobility and overall function without causing excessive strain on the joints. Choices B, C, and D are incorrect because splinting affected joints, performing passive range of motion exercises, or beginning a training program of lifting weights and running can potentially exacerbate symptoms and cause additional stress on the joints, which is not recommended for individuals with juvenile rheumatoid arthritis.

3. When should the charge nurse intervene based on the observed behavior?

• A. Two staff members are overheard talking about a cure for AIDS outside a client's room.
• B. A hospital transporter is reading a client's history and physical while waiting for an elevator.
• C. A UAP tells a client, 'It's hard to quit drinking but Alcoholics Anonymous helped me.'
• D. Two visitors are discussing a hospitalized client's history of drug abuse in the visitor's lounge.

Correct answer: B

Rationale: The hospital transporter reading a client's history and physical without a legitimate need violates patient confidentiality. This behavior requires immediate intervention to protect the client's privacy and confidentiality rights.

4. A client with type 2 diabetes mellitus is prescribed metformin (Glucophage). Which instruction should the nurse provide?

• A. Take the medication on an empty stomach.
• B. Limit your fluid intake while on this medication.
• C. Monitor your blood glucose levels regularly.
• D. Avoid eating foods high in potassium.

Correct answer: C

Rationale: Monitoring blood glucose levels regularly is crucial for clients with type 2 diabetes who are taking metformin. This helps assess the effectiveness of the medication in managing blood sugar levels and allows for timely adjustments in the treatment plan if needed. By monitoring blood glucose levels, the client and healthcare team can work together to achieve optimal diabetes control and prevent complications associated with uncontrolled blood sugar levels.

5. A client with a history of chronic alcohol abuse is at risk for which of the following conditions?

• A. Liver cirrhosis
• B. Renal failure
• C. Chronic obstructive pulmonary disease (COPD)
• D. Peptic ulcer disease

Correct answer: A

Rationale: Chronic alcohol abuse can lead to liver cirrhosis due to long-term liver damage. Alcohol consumption over time can cause inflammation and scarring of the liver, eventually leading to cirrhosis. This condition can severely impact liver function and may progress to liver failure if not addressed.

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