Nursing Elites

1. A client has a prescription for a 24-hour urine collection. Which of the following actions should be taken by the healthcare provider?

• A. Discard the first voiding.
• B. Keep the urine at room temperature.
• C. Collect the first voiding.
• D. Keep the urine in a sterile container.

Correct answer: A

Rationale: Discarding the first voiding is necessary when initiating a 24-hour urine collection to ensure that the collection starts with an empty bladder. This step helps in obtaining an accurate measurement of substances excreted over the 24-hour period without any carryover from the previous voids. Keeping the urine at room temperature or in a sterile container is not specific to the initiation of the collection. Therefore, the correct action is to discard the first voiding. Choice B is incorrect because keeping urine at room temperature is important for some tests, but it is not specific to the initiation of a 24-hour urine collection. Choice C is incorrect because collecting the first voiding would lead to inaccurate results as the bladder is not empty at the start. Choice D is incorrect because while keeping urine in a sterile container is generally a good practice, it is not a specific step for initiating a 24-hour urine collection.

2. A client has a new prescription for a metered-dose inhaler (MDI). Which of the following statements indicates an understanding of the teaching?

• A. I will shake the inhaler before use.
• B. I will breathe out forcefully after inhaling the medication.
• C. I will take the medication with food.
• D. I will use a spacer with the inhaler.

Correct answer: A

Rationale: The correct answer is A: 'I will shake the inhaler before use.' Shaking the inhaler before use is crucial to ensure proper mixing of the medication inside the inhaler. This action helps to disperse the medication evenly, allowing for consistent dosing during inhalation. Choices B, C, and D are incorrect. Breathing out forcefully after inhaling the medication, taking the medication with food, and using a spacer with the inhaler are not related to the correct use of a metered-dose inhaler. These actions may not lead to optimal medication delivery and do not demonstrate an understanding of the proper technique for using an MDI.

3. When planning care for a client with a pressure ulcer, which intervention should the nurse include in the plan?

• A. Massage the reddened area.
• B. Apply a donut-shaped cushion.
• C. Reposition the client every 3 hours.
• D. Use a transparent film dressing.

Correct answer: D

Rationale: The correct intervention for a client with a pressure ulcer is to use a transparent film dressing. This dressing provides a protective barrier against external contaminants while allowing for wound inspection, promoting healing. Massaging the reddened area can cause further damage to the skin and should be avoided. Donut-shaped cushions can increase pressure on the ulcer site rather than alleviate it. Repositioning the client every 2 hours is a preventive measure for pressure ulcers, but once an ulcer has developed, using a transparent film dressing is a more appropriate intervention to facilitate healing and protect the wound site.

4. A healthcare provider is planning care for a client who has a new prescription for a high-fiber diet. Which of the following foods should the healthcare provider recommend?

• A. White bread
• B. Canned fruit
• C. Cheese
• D. Brown rice

Correct answer: D

Rationale: Brown rice is a whole grain that is high in fiber, making it an excellent choice for a high-fiber diet. Foods like white bread, canned fruit, and cheese are typically low in fiber and would not be the best recommendation for a high-fiber diet. White bread is processed and lacks the fiber content found in whole grains like brown rice. Canned fruit, although containing some fiber, often has added sugars and lower fiber content compared to fresh fruits. Cheese is a dairy product that is generally low in fiber and not a significant source of dietary fiber compared to whole grains.

5. When planning to perform a sterile dressing change for a client, which of the following actions should a healthcare professional take?

• A. Wear sterile gloves to remove the old dressing.
• B. Cleanse the wound with an antiseptic solution.
• C. Use clean gloves to apply the new dressing.
• D. Open sterile supplies before donning sterile gloves.

Correct answer: D

Rationale: Opening sterile supplies before donning sterile gloves is a critical step in maintaining the sterility of the supplies during a dressing change procedure. By doing so, the healthcare professional ensures that they do not touch non-sterile surfaces with their hands once sterile gloves are worn, reducing the risk of introducing pathogens to the wound and minimizing the potential for contamination.

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