Nursing Elites

1. After a laparoscopic cholecystectomy, what is the most important instruction the nurse should give the client regarding post-operative care at home?

• A. Avoid lifting heavy objects for at least a week.
• B. Follow a low-fat diet.
• C. Monitor the incision sites for signs of infection.
• D. Resume normal activities as tolerated.

Correct answer: C

Rationale: Monitoring the incision sites for signs of infection is crucial after a laparoscopic cholecystectomy. Infections can lead to serious complications if not detected early. While avoiding heavy lifting and following a low-fat diet are important aspects of recovery, monitoring for infection takes precedence as it directly impacts the client's immediate post-operative well-being. Therefore, option C is the correct answer as it addresses the most critical aspect of post-operative care.

2. When a woman in early pregnancy is leaving the clinic, she blushes and asks the nurse if it is true that sex during pregnancy is bad for the baby. What is the best response for the nurse to give?

• A. The baby is protected by the sac. Sex is perfectly alright.
• B. It is unlikely to harm the baby. What you do with your personal life is your concern.
• C. Intercourse during pregnancy is usually alright, but you need to ask the doctor if it is acceptable for you.
• D. In a normal pregnancy, intercourse will not harm the baby. However, many women experience a change in desire. How are you feeling?

Correct answer: D

Rationale: Choice D is the best response as it reassures the patient that intercourse in a normal pregnancy will not harm the baby. It also shows empathy by acknowledging that many women experience changes in sexual desire during pregnancy. This response validates the patient's concerns and opens up a dialogue about her feelings. Choice A is incorrect as it lacks information about changes in sexual desire and oversimplifies the situation. Choice B is dismissive of the patient's concerns and does not provide adequate information. Choice C is not the best response as it suggests asking the doctor without offering immediate reassurance or addressing the patient's worries.

3. The PN notes that a UAP is ambulating a male client who had a stroke and has right-sided weakness. The UAP is walking on the client's left side. Which action should the PN take?

• A. Instruct the UAP to walk on the client's affected side
• B. Take over the ambulation and provide guidance to the UAP immediately
• C. Provide the client with an assistive device, such as a cane or walker
• D. Tell the UAP to take the client back to his room

Correct answer: A

Rationale: The correct action for the PN to take is to instruct the UAP to walk on the client’s affected side. This is essential to provide the necessary support and prevent falls, especially when the client has weakness on one side due to a stroke. Walking on the affected side helps provide stability and assistance to the weaker side. Choice B is incorrect because it would be more appropriate for the PN to provide immediate guidance and correct the UAP's positioning rather than taking over the task completely. Choice C is incorrect because while assistive devices may be beneficial, the immediate concern is the UAP's positioning during ambulation, not providing the client with an assistive device. Choice D is incorrect as there is no indication to return the client to his room unless it is necessary for his safety or well-being.

4. What is the most common genetic cause of intellectual disability?

• A. Down syndrome
• B. Fragile X syndrome
• C. Prader-Willi syndrome
• D. Turner syndrome

Correct answer: B

Rationale: The correct answer is Fragile X syndrome because it is the most common inherited cause of intellectual disability, resulting from a mutation in the FMR1 gene. Down syndrome, Prader-Willi syndrome, and Turner syndrome are not the most common genetic causes of intellectual disability. Down syndrome is caused by the presence of an extra chromosome 21, Prader-Willi syndrome results from specific genetic abnormalities on chromosome 15, and Turner syndrome is characterized by the absence of part or all of one of the X chromosomes.

5. Thirty minutes after receiving IV morphine, a postoperative client continues to rate pain as 7 on a 10-point scale. Which action should the PN implement first?

• A. Call healthcare provider to request a different analgesic
• B. Determine when morphine can be given again
• C. Implement complementary pain relief methods
• D. Observe dressing to determine the presence of bleeding

Correct answer: C

Rationale: The most appropriate action for the PN to implement first is to implement complementary pain relief methods. This includes repositioning the client, applying heat or cold packs, or using relaxation techniques. These strategies can provide additional pain relief before the next dose of medication is due or before seeking further instructions from the healthcare provider. Calling the healthcare provider immediately to request a different analgesic (Choice A) may not be necessary at this moment since other non-pharmacological methods can be attempted first. Determining when morphine can be given again (Choice B) is important but addressing the client's immediate pain relief takes precedence. Observing the dressing for bleeding (Choice D) is important but not the first priority when the client is experiencing unrelieved pain.

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