Nursing Elites

1. A client has pyelonephritis and expresses embarrassment about discussing symptoms. How should the nurse respond?

• A. Assure the client that their symptoms will be kept confidential.
• B. Acknowledge the client's discomfort and avoid discussing elimination topics.
• C. Encourage the use of familiar language and assure the client they can take their time.
• D. Offer the client a nurse of the same gender to provide care.

Correct answer: C

Rationale: When a client expresses embarrassment or discomfort in discussing symptoms related to sensitive topics like elimination and the genitourinary area, the nurse should respond by encouraging the client to use words they are comfortable with. This helps the client feel more at ease and opens up communication. Offering a nurse of the same gender may not address the client's discomfort with discussing symptoms. Assuring confidentiality is important, but it should not be promised in a way that may not be fulfilled. Avoiding the topic of elimination entirely does not address the client's feelings or promote effective communication.

2. What is the most important nursing intervention for a patient with increased intracranial pressure (ICP)?

• A. Elevate the head of the bed to 30 degrees.
• B. Administer diuretics to reduce fluid volume.
• C. Administer corticosteroids to reduce inflammation.
• D. Keep the patient in a supine position.

Correct answer: A

Rationale: Elevating the head of the bed to 30 degrees is crucial for a patient with increased intracranial pressure (ICP) because it helps promote venous drainage from the brain, thereby reducing ICP. Keeping the head of the bed elevated helps facilitate cerebral perfusion and can prevent a further increase in ICP. Administering diuretics (Choice B) may be considered in some cases to reduce fluid volume, but it is not the most critical intervention for immediate ICP management. Administering corticosteroids (Choice C) is not typically indicated for managing increased ICP unless there is a specific underlying condition requiring their use. Keeping the patient in a supine position (Choice D) can actually worsen ICP by impeding venous outflow from the brain, making it an incorrect choice for this scenario.

3. A client tells the nurse that he has been experiencing frequent heartburn and has been 'living on antacids.' For which acid-base disturbance does the nurse recognize a risk?

• A. Metabolic acidosis
• B. Metabolic alkalosis
• C. Respiratory acidosis
• D. Respiratory alkalosis

Correct answer: B

Rationale: The correct answer is B: Metabolic alkalosis. In this scenario, the client's frequent use of antacids containing alkaline components can lead to an excess of bicarbonate in the body, causing metabolic alkalosis. Oral antacids work by neutralizing stomach acid, potentially leading to an alkaline shift in the body's pH balance. Choices A, C, and D are incorrect. Metabolic acidosis is not typically associated with antacid use. Respiratory acidosis and respiratory alkalosis are related to respiratory system dysfunction rather than antacid ingestion.

4. A nurse administers scopolamine as prescribed to a client in preparation for surgery. For which side effect of this medication does the nurse monitor the client?

• A. Pupil constriction
• B. Increased urine output
• C. Complaints of dry mouth
• D. Complaints of feeling sweaty

Correct answer: D

Rationale: The correct answer is D: 'Complaints of feeling sweaty.' Scopolamine, an anticholinergic medication, commonly causes the side effect of decreased sweating, not increased urine output or pupil constriction. While dry mouth is a possible side effect, it is less likely than the altered sweating pattern. Therefore, the nurse should monitor the client for complaints of feeling sweaty due to the potential side effect of decreased sweating associated with scopolamine.

5. A nurse plans care for an older adult client. Which interventions should the nurse include in this client’s plan of care to promote kidney health? (Select all that apply.)

• A. Ensure adequate fluid intake.
• B. Leave the bathroom light on at night.
• C. Encourage use of the toilet every 6 hours.
• D. A & B

Correct answer: D

Rationale: The correct interventions to promote kidney health in an older adult client include ensuring adequate fluid intake to maintain hydration and leaving the bathroom light on at night to promote safe ambulation. Adequate hydration supports kidney function and helps prevent urinary tract infections. Encouraging the use of the toilet every 6 hours is not specific to kidney health and may not be individualized to the client's needs. Providing thorough perineal care after each voiding is important for hygiene but not directly related to promoting kidney health. Assessing for urinary retention and urinary tract infections is crucial but falls under assessment rather than interventions for promoting kidney health specifically.

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