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 with hypothyroidism is being taught about dietary management. Which statement by the client indicates an understanding of the teaching?

• A. I should increase my intake of iodine-rich foods.
• B. I should decrease my intake of iodine-rich foods.
• C. I should increase my intake of potassium-rich foods.
• D. I should decrease my intake of sodium-rich foods.

Correct answer: A

Rationale: The correct answer is A. Increasing intake of iodine-rich foods is beneficial for clients with hypothyroidism as iodine is essential for thyroid hormone synthesis. Adequate iodine intake helps to support thyroid function in individuals with hypothyroidism, making choice A the most appropriate response indicating an understanding of the dietary management for this condition. Choices B, C, and D are incorrect because decreasing iodine-rich foods, increasing potassium-rich foods, or decreasing sodium-rich foods are not the recommended dietary modifications for hypothyroidism. In fact, decreasing iodine-rich foods could exacerbate hypothyroidism due to the essential role of iodine in thyroid hormone production.

3. When caring for a client with a prescription for wound irrigation, which action should the nurse take?

• A. Use a 10-mL syringe with an 18-gauge needle.
• B. Cleanse the wound from the center outward.
• C. Apply a wet-to-dry dressing.
• D. Pack the wound tightly with gauze.

Correct answer: B

Rationale: When caring for a client with a prescription for wound irrigation, the nurse should cleanse the wound from the center outward. This technique helps prevent the introduction of microorganisms into the wound, reducing the risk of contamination and promoting effective wound healing. By using a circular motion from the cleanest area to the least clean areas, debris and bacteria are moved away from the wound site, decreasing the chances of infection.

4. A client is receiving continuous enteral feedings through a nasogastric tube. Which of the following actions should the nurse take?

• A. Elevate the head of the bed to 30°
• B. Flush the tube with 50 mL of water every 2 hours
• C. Replace the feeding bag and tubing every 72 hours
• D. Check the client's gastric residual every 8 hours

Correct answer: A

Rationale: Elevating the head of the bed to 30° is the correct action to take when a client is receiving continuous enteral feedings through a nasogastric tube. This position helps prevent aspiration of the enteral feedings into the lungs, reducing the risk of aspiration pneumonia. Additionally, elevating the head of the bed promotes proper digestion and absorption of the feedings by utilizing gravity to facilitate movement into the stomach and through the gastrointestinal tract. Flushing the tube with water every 2 hours (Choice B) is not necessary for continuous feedings and may disrupt the feeding schedule. Replacing the feeding bag and tubing every 72 hours (Choice C) is not the standard recommendation unless there are specific concerns or complications. Checking the client's gastric residual every 8 hours (Choice D) is important but not the immediate action needed to prevent aspiration during enteral feedings.

5. When teaching a client with a new diagnosis of hepatitis about dietary management, which of the following statements should the nurse include?

• A. Increase your intake of high-protein foods.
• B. Decrease your intake of high-protein foods.
• C. Avoid foods that contain lactose.
• D. Increase your intake of dairy products.

Correct answer: B

Rationale: For a client with hepatitis, it is important to decrease the intake of high-protein foods. High-protein foods can be harder for the liver to process and may exacerbate symptoms or contribute to liver damage. Recommending a diet with moderate protein intake is beneficial for managing symptoms and promoting liver health. Choice A is incorrect as increasing high-protein foods can strain the liver. Choice C is not directly related to hepatitis unless there is an intolerance present. Choice D is also incorrect because increasing dairy products may not be suitable for all individuals with hepatitis, especially if there are underlying liver conditions that could be aggravated by certain dairy components.

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