Nursing Elites

1. A healthcare professional reviews the allergy list of a client scheduled for an intravenous urography. Which client allergy should prompt urgent contact with the healthcare provider?

• A. Seafood
• B. Penicillin
• C. Bee stings
• D. Red food dye

Correct answer: A

Rationale: Clients with seafood allergies should alert healthcare professionals to urgently contact the healthcare provider before an intravenous urography. The standard dyes used in this procedure can trigger severe allergic reactions in individuals with seafood allergies. Penicillin, bee stings, and red food dye allergies do not pose a direct threat during intravenous urography, making them less critical for immediate intervention.

2. A client with chronic renal failure is receiving sodium polystyrene sulfonate (Kayexalate). The nurse should monitor the client for which of the following?

• A. Hyponatremia.
• B. Hypokalemia.
• C. Hyperkalemia.
• D. Hypocalcemia.

Correct answer: C

Rationale: Correct Answer: The correct answer is C, 'Hyperkalemia.' Sodium polystyrene sulfonate (Kayexalate) is a medication used to treat high potassium levels (hyperkalemia) by exchanging sodium ions for potassium ions in the intestines, leading to potassium removal from the body. Therefore, the nurse should monitor the client for changes in potassium levels to assess the effectiveness of the medication and prevent potential complications related to hyperkalemia. Choice A, 'Hyponatremia,' is incorrect as Kayexalate does not primarily affect sodium levels. Choice B, 'Hypokalemia,' is incorrect as Kayexalate is used to treat high potassium levels, not low. Choice D, 'Hypocalcemia,' is incorrect as Kayexalate does not directly impact calcium levels.

3. A client who has just undergone a skin biopsy is listening to discharge instructions from the nurse. The nurse determines that the client has misunderstood the directions if the client indicates that as part of aftercare he plans to:

• A. Use the antibiotic ointment as prescribed
• B. Return in 7 days to have the sutures removed
• C. Apply cool compresses to the site twice a day for 20 minutes
• D. Call the physician if excessive drainage from the wound occurs

Correct answer: C

Rationale: The correct answer is C. Applying cool compresses to the site twice a day for 20 minutes is not a recommended aftercare practice for a skin biopsy. After a skin biopsy, it is important to keep the dressing dry and in place for a minimum of 8 hours. Choice A is correct as using the antibiotic ointment as prescribed is a common post-biopsy instruction to prevent infection. Choice B is also correct as returning in 7 days to have the sutures removed is part of the typical follow-up care after a skin biopsy. Choice D is correct as it is important to call the physician if excessive drainage from the wound occurs to prevent complications.

4. What is the most common cause of peptic ulcers?

• A. Helicobacter pylori infection
• B. NSAID use
• C. Excessive alcohol consumption
• D. Stress

Correct answer: A

Rationale: Helicobacter pylori infection is the most common cause of peptic ulcers. This bacterium can weaken the protective mucous coating of the stomach and duodenum, allowing acid to get through to the sensitive lining beneath. NSAID use (Choice B) can also cause peptic ulcers by disrupting the stomach's mucosal barrier. Excessive alcohol consumption (Choice C) and stress (Choice D) can exacerbate and contribute to ulcer formation but are not the primary cause.

5. Four hours following surgical repair of a compound fracture of the right ulna, the nurse is unable to palpate the client's right radial pulse. Which action should the nurse take first?

• A. Notify the healthcare provider of the finding immediately.
• B. Complete a neurovascular assessment of the right hand.
• C. Elevate the client's right hand on one or two pillows.
• D. Measure the client's blood pressure and apical pulse rate.

Correct answer: B

Rationale: Completing a neurovascular assessment of the right hand is the priority in this situation. This assessment will help determine the circulation, sensation, and movement of the affected limb, ensuring there are no complications like compartment syndrome or impaired perfusion. Notifying the healthcare provider immediately (Choice A) might be necessary but should come after assessing the client's neurovascular status. Elevating the client's right hand (Choice C) can be helpful in some cases but should not precede a neurovascular assessment. Measuring the client's blood pressure and apical pulse rate (Choice D) is important but not the priority when assessing a potential vascular compromise in the limb.

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