Nursing Elites

1. A nurse teaches a client who is recovering from a nephrectomy secondary to kidney trauma. Which statement should the nurse include in this client’s teaching?

• A. Since you only have one kidney, a salt and fluid restriction is required.
• B. Your therapy will include hemodialysis while you recover.
• C. Medication will be prescribed to control your high blood pressure.
• D. You need to avoid participating in contact sports like football.

Correct answer: D

Rationale: Clients with one kidney need to avoid contact sports because the kidneys are easily injured. The client will not be required to restrict salt and fluids, end up on dialysis, or have new hypertension because of the nephrectomy.

2. A female patient will receive doxycycline to treat a sexually transmitted infection (STI). What information will the nurse include when teaching this patient about this medication?

• A. Nausea and vomiting are uncommon adverse effects.
• B. The drug may cause possible teratogenic effects.
• C. Increase intake of dairy products with each dose of this medication.
• D. Use a backup method of contraception if taking oral contraceptives.

Correct answer: D

Rationale: The correct answer is D. The desired action of oral contraceptives can be reduced when taken with tetracyclines like doxycycline. Therefore, patients on oral contraceptives should be advised to use a backup contraception method while taking doxycycline. Choice A is incorrect because nausea and vomiting are common adverse effects of doxycycline. Choice B is incorrect because doxycycline is not known for causing teratogenic effects. Choice C is incorrect because dairy products can interfere with the absorption of doxycycline, so they should be avoided when taking this medication.

3. The nurse is caring for a client with chronic renal failure who is on a low-potassium diet. Which of the following foods should the client avoid?

• A. Bananas
• B. Potatoes
• C. Rice
• D. Apples

Correct answer: A

Rationale: Bananas are high in potassium content, which can lead to hyperkalemia in clients with chronic renal failure who are on a low-potassium diet. Therefore, it is crucial for these clients to avoid bananas. Potatoes, rice, and apples are lower in potassium compared to bananas and are generally considered safe for consumption in clients with chronic renal failure on a low-potassium diet.

4. A confused client with pneumonia is admitted with an indwelling catheter in place. During interdisciplinary rounds the following day, which question should the nurse ask the primary health care provider?

• A. Do you want daily weights on this client?
• B. Will the client be able to return home?
• C. Can we discontinue the indwelling catheter?
• D. Should we get another chest x-ray today?

Correct answer: C

Rationale: An indwelling catheter dramatically increases the risks of urinary tract infection and urosepsis. Nursing staff should ensure that catheters are left in place only as long as they are medically needed. The nurse should inquire about removing the catheter. All other questions might be appropriate, but because of client safety, this question takes priority.

5. Oxygen via nasal cannula has been prescribed for a client with emphysema. The nurse checks the physician’s orders to ensure that the prescribed flow is not greater than:

• A. 1 L/min
• B. 3 L/min
• C. 4 L/min
• D. 6 L/min

Correct answer: B

Rationale: The correct answer is B, 3 L/min. Clients with emphysema typically receive oxygen at a flow rate of 1 to 2 L/min, with a maximum of 3 L/min. Higher flow rates can lead to oxygen toxicity in these clients, so it's crucial to adhere to the prescribed limits. Choice A (1 L/min) is too low and may not provide adequate oxygenation for the client. Choices C (4 L/min) and D (6 L/min) exceed the recommended flow rates for clients with emphysema and can increase the risk of oxygen toxicity.

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