Nursing Elites

1. A nurse is caring for a client with rheumatoid arthritis who has been taking prednisone. Which of the following findings should the nurse identify as an adverse effect of this medication?

• A. Weight loss
• B. Hypoglycemia
• C. Hypertension
• D. Hyperkalemia

Correct answer: C

Rationale: The correct answer is C, 'Hypertension.' Prednisone, a corticosteroid, can lead to hypertension as an adverse effect. Prednisone can cause sodium retention and potassium loss, leading to increased blood pressure. Weight loss (choice A) is not a common adverse effect of prednisone; in fact, weight gain is more common. Hypoglycemia (choice B) is not typically associated with prednisone use; instead, hyperglycemia is a common concern. Hyperkalemia (choice D) is also unlikely with prednisone use; instead, hypokalemia is a potential electrolyte imbalance.

2. A client is to undergo a liver biopsy. Which of the following instructions should the nurse provide to the client following the procedure?

• A. Lie on your left side.
• B. Lie on your right side.
• C. Increase your fluid intake.
• D. Decrease your fluid intake.

Correct answer: B

Rationale: After a liver biopsy, the nurse should instruct the client to lie on the right side. This position helps apply pressure to the biopsy site, promoting hemostasis and reducing the risk of bleeding. Lying on the left side may not provide adequate pressure to the site. Increasing fluid intake is generally beneficial to prevent dehydration and aid in the recovery process, whereas decreasing fluid intake could lead to dehydration and possible complications. Therefore, the correct instruction is to lie on the right side.

3. What dietary recommendations should be provided to a patient with GERD?

• A. Avoid mint and spicy foods
• B. Eat large meals before bed
• C. Consume liquids with meals
• D. Avoid foods high in potassium

Correct answer: A

Rationale: The correct recommendation for a patient with GERD is to avoid mint and spicy foods. These types of foods can trigger acid reflux and worsen GERD symptoms. Choice B is incorrect as eating large meals before bed can increase the likelihood of acid reflux due to increased pressure on the lower esophageal sphincter. Choice C is also incorrect as consuming liquids with meals can cause distension in the stomach, potentially leading to reflux. Choice D is not directly related to GERD, as foods high in potassium are generally healthy and not specifically problematic for GERD patients.

4. A patient with GERD is receiving dietary teaching from a nurse. What should the nurse recommend?

• A. Avoid mint and pepper
• B. Increase fluid intake before meals
• C. Eat three large meals per day
• D. Avoid drinking water with meals

Correct answer: A

Rationale: The correct recommendation for a patient with GERD is to avoid foods like mint and pepper, as these can help reduce gastric acid secretion and alleviate symptoms. Mint and pepper are known to relax the lower esophageal sphincter, leading to increased reflux. Increasing fluid intake before meals (choice B) may worsen GERD symptoms by distending the stomach. Eating three large meals per day (choice C) can also aggravate GERD because large meals can lead to increased gastric pressure and reflux. Avoiding drinking water with meals (choice D) is generally recommended for GERD; however, the most crucial advice in this case is to avoid mint and pepper for better symptom management.

5. What does continuous bubbling in the water seal chamber of a chest tube indicate?

• A. An air leak
• B. A blockage in the chest tube
• C. Normal chest tube function
• D. Malfunction in the drainage system

Correct answer: A

Rationale: Continuous bubbling in the water seal chamber indicates an air leak in the chest tube system. This bubbling occurs when air is escaping through the tube and entering the water seal chamber. Choice B, a blockage in the chest tube, is incorrect as continuous bubbling does not suggest a blockage. Choice C, normal chest tube function, is incorrect because continuous bubbling is not an expected finding in a properly functioning chest tube. Choice D, a malfunction in the drainage system, is incorrect as continuous bubbling specifically points towards an air leak, not a general malfunction.

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