Nursing Elites

1. A nurse is preparing to administer total parenteral nutrition (TPN) to a client. Which of the following findings indicates a need to obtain a new bag of TPN before administering?

• A. The TPN solution has an oily appearance and a layer of fat on top of the solution.
• B. The TPN solution contains added electrolytes, vitamins, and trace elements.
• C. The bag of TPN was prepared by the pharmacy 12 hours prior.
• D. The bag of TPN is labeled with the client's name, medical record number, and prescription.

Correct answer: A

Rationale: A TPN solution with an oily appearance and a layer of fat on top indicates that the solution is 'cracked' and should not be used as it may have separated or deteriorated. This finding suggests a need to obtain a new bag of TPN before administering. Options B, C, and D are normal aspects of TPN administration. Option B confirms the presence of essential components in the TPN solution, option C provides information about the preparation time, and option D ensures proper identification and matching of the TPN with the correct client.

2. A nurse is assessing a client for signs of allergic reaction. Which of the following should the nurse look for?

• A. Fever
• B. Rash
• C. Fatigue
• D. Increased appetite

Correct answer: B

Rationale: Correct! When assessing a client for signs of an allergic reaction, a nurse should look for a rash. A rash is a common manifestation of an allergic response, such as contact dermatitis or hives. It is important to recognize and assess rashes promptly as they can indicate an allergic reaction.\nOption A, fever, is not typically a primary sign of an allergic reaction but may occur in severe cases. Option C, fatigue, is a general symptom and not specific to allergic reactions. Option D, increased appetite, is not a common sign of an allergic reaction and is more likely related to other conditions or factors.

3. A nurse is teaching the parents of a newborn how to care for their child's uncircumcised penis. Which of the following instructions should the nurse include?

• A. Retract the foreskin gently without force.
• B. Use a cotton swab to clean under the foreskin.
• C. Apply petroleum jelly to the foreskin.
• D. Wash the penis once a day with soap and water.

Correct answer: D

Rationale: The correct answer is to wash the penis once a day with soap and water. It is important to advise against forcefully retracting the foreskin as it can cause pain and injury. Using a cotton swab is not recommended as it can introduce foreign particles, and applying petroleum jelly is unnecessary and may lead to issues. Washing with soap and water is sufficient for hygiene without the need for additional products or manipulation of the foreskin.

4. In the nursing process, the evaluation phase is used to determine:

• A. Value of the nursing intervention
• B. Accuracy of problem identification
• C. Quality of the plan of care
• D. Degree of outcome achievement

Correct answer: D

Rationale: The evaluation phase of the nursing process is used to determine the degree of outcome achievement. It assesses whether the goals and outcomes set during the planning phase were met. Choice A is incorrect because it focuses on the worth of the intervention rather than the achievement of outcomes. Choice B is incorrect as it pertains to the assessment phase where problems are identified. Choice C is incorrect as it refers to the planning phase where the care plan is developed, not evaluated.

5. A nurse in a provider's office is assessing a client who reports a decrease in the effectiveness of their arthritis medication. Which of the following client information should the nurse identify as a contributing factor?

• A. The client has a history of recurring bowel inflammation.
• B. The client has recently increased their exercise regimen.
• C. The client is taking herbal supplements.
• D. The client is experiencing increased stress.

Correct answer: A

Rationale: The correct answer is A. Recurring bowel inflammation can decrease gastrointestinal motility, affecting the absorption of oral medications. This can lead to decreased effectiveness of the arthritis medication. Choice B is incorrect because increasing exercise would not typically impact the absorption of arthritis medication. Choice C is incorrect as herbal supplements may not directly affect the absorption of conventional arthritis medication. Choice D is also incorrect as stress, while it can impact overall health, is less likely to directly affect the effectiveness of arthritis medication compared to gastrointestinal issues.

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