Nursing Elites

1. A client is being taught about fecal occult blood testing (FOBT) for colorectal cancer screening. Which of the following statements should the nurse include in the teaching?

• A. Your provider will use a stool sample obtained during a digital rectal examination to perform the test.
• B. Your provider will recommend a stimulant laxative before the test to empty the bowel.
• C. You should start annual fecal occult blood testing for colorectal cancer screening at the age of 40.
• D. You should avoid corticosteroids before the test.

Correct answer: D

Rationale: The correct answer is D because the nurse should advise the client to avoid corticosteroids, anti-inflammatory medications, and vitamin C before fecal occult blood testing to prevent false-positive results. Choice A is incorrect as stool samples for FOBT are usually collected using a kit at home. Choice B is incorrect because stimulant laxatives are not typically used before FOBT. Choice C is incorrect as guidelines recommend starting colorectal cancer screening at the age of 50, not 40.

2. A patient reports abdominal cramping after enema administration. What is the appropriate action?

• A. Lower the height of the solution container
• B. Stop the procedure and remove tubing
• C. Increase the flow of enema solution
• D. Continue the enema at a slower rate

Correct answer: A

Rationale: Lowering the height of the enema solution container is the appropriate action when a patient reports abdominal cramping after enema administration. This helps reduce the flow rate of the solution, potentially alleviating the cramping. Stopping the procedure and removing tubing (Choice B) would be too abrupt and may not address the issue. Increasing the flow of enema solution (Choice C) could exacerbate the cramping by adding more pressure. Continuing the enema at a slower rate (Choice D) might not provide immediate relief compared to lowering the height of the solution container.

3. What is the primary nursing action for a patient experiencing continuous bubbling in the chest tube water seal chamber?

• A. Tighten the connections of the chest tube system
• B. Clamp the chest tube
• C. Continue monitoring the chest tube
• D. Replace the chest tube system

Correct answer: A

Rationale: The correct answer is to tighten the connections of the chest tube system. Continuous bubbling in the chest tube water seal chamber indicates an air leak. By tightening the connections of the chest tube system, the nurse can often resolve the issue by ensuring there are no loose connections allowing air to enter. Clamping the chest tube or replacing the chest tube system are not appropriate actions in this situation. Clamping the tube can cause a dangerous buildup of pressure, while replacing the system should only be considered if tightening the connections does not resolve the air leak.

4. What lab value is a priority in monitoring a patient with HIV?

• A. CD4 T-cell count below 180 cells/mm3
• B. Hemoglobin levels
• C. Serum albumin levels
• D. White blood cell count

Correct answer: A

Rationale: The correct answer is A: CD4 T-cell count below 180 cells/mm3. Monitoring the CD4 T-cell count is crucial in patients with HIV as it reflects the status of the immune system. A CD4 T-cell count below 180 cells/mm3 indicates severe immunocompromise and an increased risk of opportunistic infections. This value guides the initiation of prophylaxis for infections and the timing of antiretroviral therapy initiation. Choices B, C, and D are not the priority lab values in monitoring patients with HIV. Hemoglobin levels primarily assess for anemia, serum albumin levels reflect nutritional status, and white blood cell count is more generalized and may not specifically indicate the severity of immunocompromise in HIV patients.

5. A nurse at a provider's office is interviewing a client who has multiple sclerosis and has been taking dantrolene for several months. Which of the following client statements should the nurse identify as an indication that the medication is effective?

• A. I don't have muscle spasms as frequently.
• B. I haven't gotten any colds, even though it is flu season.
• C. I feel like my nerve pain has improved.
• D. It is easier to urinate now.

Correct answer: A

Rationale: The correct answer is A: 'I don't have muscle spasms as frequently.' Dantrolene is a medication that relaxes skeletal muscles and is commonly prescribed to treat muscle spasms in clients with multiple sclerosis. Therefore, a reduction in muscle spasms frequency would be an indication of the medication's effectiveness. Choices B, C, and D are incorrect because dantrolene is not indicated for preventing colds, improving nerve pain, or easing urination. The focus should be on the medication's intended purpose, which is to address muscle spasms in clients with multiple sclerosis.

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