Nursing Elites

1. A client who has had two episodes of bacterial cystitis in the last 6 months is being assessed by a nurse. Which questions should the nurse ask? (Select all that apply.)

• A. How much water do you drink every day?
• B. Do you take estrogen replacement therapy?
• C. Does anyone in your family have a history of cystitis?
• D. All of the Above

Correct answer: D

Rationale: The correct answers are all of the above (D). Asking about fluid intake (choice A) is important as it can affect the risk of cystitis. Estrogen levels (choice B) can also impact the likelihood of recurrent cystitis. Family history (choice C) is relevant as certain genetic factors can predispose individuals to cystitis. Cranberry juice, not grapefruit or orange juice, has been found to reduce the risk of bacterial cystitis by increasing the acidic pH. Therefore, choices A, B, and C are all pertinent questions to ask during the assessment of a client with recurrent bacterial cystitis.

2. A client is tested for HIV with the use of an enzyme-linked immunosorbent assay (ELISA), and the test result is positive. The nurse should tell the client that:

• A. HIV infection has been confirmed
• B. The client probably has an opportunistic infection
• C. The test will need to be confirmed with the use of a Western blot
• D. A positive test is a normal result and does not mean that the client is infected with HIV

Correct answer: C

Rationale: When an ELISA test for HIV is positive, it is essential to confirm the result with a Western blot. The Western blot is the confirmatory test for HIV. Choice A is incorrect because a positive ELISA test does not confirm HIV infection. Choice B is incorrect as it assumes a different diagnosis. Choice D is incorrect because a positive ELISA test does indicate potential HIV infection and requires confirmation.

3. Which food is most important to encourage a client with osteomalacia to include in a daily diet?

• A. Fortified milk and cereals
• B. Citrus fruits and juices
• C. Green leafy vegetables
• D. Red meats and eggs

Correct answer: A

Rationale: The correct answer is A: Fortified milk and cereals. Osteomalacia is a condition caused by a deficiency in vitamin D. Fortified milk and cereals are rich sources of vitamin D, which is essential for managing osteomalacia. Citrus fruits and juices (choice B) are high in vitamin C, but vitamin D is the primary concern for osteomalacia. Green leafy vegetables (choice C) are good sources of various nutrients but not the main focus for managing osteomalacia. Red meats and eggs (choice D) are good sources of protein and other nutrients but are not as critical as fortified milk and cereals for addressing vitamin D deficiency in osteomalacia.

4. A client who is scheduled for cardiac catheterization to rule out coronary occlusion should be informed by the nurse that:

• A. The procedure is performed in a darkened room in the radiology department
• B. It is necessary to lie quietly on a hard x-ray table for about 4 hours
• C. The room is bright and well lit, and it is best to keep the eyes closed
• D. The client may have feelings of warmth or flushing during the procedure

Correct answer: D

Rationale: Before cardiac catheterization, the nurse should inform the client that the procedure is performed in a darkened room in the radiology department, not the operating room. The client should expect to lie still on an x-ray table for the duration of the procedure, not necessarily for about 4 hours. Keeping the eyes closed is not necessary as the room is usually dimly lit. The client may experience sensations of warmth or flushing during the procedure due to catheter passage and dye injection, making choice D the correct answer.

5. After a urography, a client is instructed by a nurse. Which instruction should the nurse include in this client’s discharge teaching?

• A. Avoid direct contact with your urine for 24 hours until the dye clears.
• B. You may experience dribbling of urine for several weeks post-procedure.
• C. Drink at least 3 liters of fluids today to assist in dye elimination.
• D. Your skin may turn slightly yellow from the dye used in this procedure.

Correct answer: C

Rationale: It is important for the client to increase fluid intake to aid in the rapid elimination of the potentially nephrotoxic dye used in urography. This instruction will help prevent any adverse effects related to the dye. Choices A, B, and D are incorrect because the dye used in urography is not radioactive, so there is no need to avoid direct contact with urine, urine dribbling is not a common post-procedure occurrence, and the dye should not cause the client's skin to change color.

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