Nursing Elites

1. A client is experiencing urinary incontinence, and a nurse is providing care. Which of the following recommendations should the nurse include in the teaching plan for this client?

• A. Drink large amounts of water before bedtime
• B. Perform Kegel exercises regularly
• C. Limit fiber intake in the diet to avoid bowel irritation
• D. Increase intake of caffeinated and carbonated beverages

Correct answer: B

Rationale: The correct recommendation for a client experiencing urinary incontinence is to perform Kegel exercises regularly. These exercises help strengthen the pelvic floor muscles, improving bladder control and reducing urinary incontinence. Option A is incorrect because drinking large amounts of water before bedtime can worsen urinary incontinence by increasing urine production. Option C is incorrect as fiber is important for bowel health and limiting it may not be beneficial for the client. Option D is incorrect as caffeinated and carbonated beverages can irritate the bladder and worsen urinary incontinence, so they should be avoided.

2. A nurse is planning care for a client who has a sealed radiation implant and is to remain in the hospital for one week. Which of the following should the nurse include in the plan of care?

• A. Remove dirty linens from the room after double-bagging them
• B. Wear a dosimeter film badge while in the client’s room
• C. Limit each visitor to one hour per day
• D. Ensure family members remain at least 3 feet from the client

Correct answer: B

Rationale: The correct answer is to wear a dosimeter film badge while in the client's room. Wearing a dosimeter helps monitor the cumulative radiation exposure of healthcare workers, ensuring their safety during care. Removing dirty linens, limiting visitor time, and maintaining a distance from the client are not directly related to radiation safety measures and are not necessary in this scenario.

3. A client with severe preeclampsia is receiving magnesium sulfate intravenously. Which action should the nurse take when toxicity occurs?

• A. Position the client supine
• B. Prepare an IV bolus of dextrose 5%
• C. Administer calcium gluconate IV
• D. Administer methylergonovine IM

Correct answer: C

Rationale: When toxicity from magnesium sulfate occurs, the nurse should administer calcium gluconate IV as it is the antidote for magnesium sulfate toxicity. Positioning the client supine may not address the toxicity issue. Administering dextrose 5% is not the appropriate intervention for magnesium sulfate toxicity. Methylergonovine is used to manage postpartum hemorrhage and is not indicated for magnesium sulfate toxicity.

4. A nurse is caring for the mother of an adolescent who was killed in a motor-vehicle crash after a school event. The mother states, 'I never should have let him take the car. It's all my fault!' Which of the following responses by the nurse is appropriate?

• A. You had no way of knowing this would happen.
• B. Most parents blame themselves when losing a child.
• C. Tell me why you feel this is your fault.
• D. You appear to be feeling overwhelmed.

Correct answer: C

Rationale: Choice C is the most appropriate response because it encourages the mother to express her feelings and explore the reasons behind her guilt. This approach allows the mother to process her emotions effectively and address her grief. Choices A and B do not directly address the mother's feelings of guilt and may not help her work through her emotions. Choice D acknowledges the mother's emotional state but does not delve into the underlying issues causing her guilt and grief.

5. A healthcare professional is verifying nasogastric tube placement by the pH of aspirated gastric fluid. Which of the following pH values provides a good indication of correct tube placement?

• A. 2
• B. 5
• C. 7
• D. 9

Correct answer: A

Rationale: The correct answer is A: '2'. Gastric contents with a pH between 0 and 4 provide a good indication of appropriate tube placement. A pH of 2 is within this range, indicating that the tube is correctly placed in the stomach. Choices B, C, and D are incorrect because a pH of 5, 7, or 9 does not fall within the expected acidic pH range of gastric fluid.

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