Nursing Elites

1. During a paracentesis procedure on a client with abdominal ascites, into which position would the nurse assist the client?

• A. Supine
• B. Upright
• C. Left side-lying
• D. Right side-lying

Correct answer: B

Rationale: During a paracentesis procedure for a client with abdominal ascites, the nurse should assist the client into an upright position. Placing the client upright allows the intestines to float posteriorly, reducing the risk of intestinal laceration during catheter insertion. Choices A, C, and D are incorrect because a supine, left side-lying, or right side-lying position would not provide the same benefit of intestinal mobility and protection during the procedure.

2. Which of the following medications is commonly prescribed for hypertension?

• A. Atenolol
• B. Aspirin
• C. Ibuprofen
• D. Metformin

Correct answer: A

Rationale: The correct answer is Atenolol. Atenolol is a beta-blocker commonly prescribed to manage hypertension due to its ability to reduce the heart rate and lower blood pressure. Options B, C, and D are incorrect because aspirin, ibuprofen, and metformin are not typically used as first-line treatments for hypertension. Aspirin is more commonly used for its antiplatelet effects, ibuprofen is a nonsteroidal anti-inflammatory drug, and metformin is primarily used for managing diabetes.

3. A client tells the clinic nurse about experiencing burning on urination, and assessment reveals that the client had sexual intercourse four days ago with a person who was casually met. Which action should the nurse implement?

• A. Observe the perineal area for a chancroid-like lesion
• B. Obtain a specimen of urethral drainage for culture
• C. Assess for perineal itching, erythema, and excoriation
• D. Identify all sexual partners in the last four days

Correct answer: B

Rationale: Obtaining a urethral drainage specimen for culture is crucial in diagnosing a potential sexually transmitted infection (STI) in this client. While assessing for perineal symptoms like itching, erythema, and excoriation (Choice C) may provide additional information, obtaining a culture is more definitive. Observing for a chancroid-like lesion (Choice A) is not as pertinent as obtaining a culture for a broader diagnostic approach. Identifying all sexual partners in the last four days (Choice D) is important for contact tracing but obtaining a specimen for culture takes priority in this scenario.

4. A nurse assesses clients on the medical-surgical unit. Which client is at greatest risk for bladder cancer?

• A. A 25-year-old female with a history of sexually transmitted diseases
• B. A 42-year-old male who has worked in a lumber yard for 10 years
• C. A 55-year-old female who has had numerous episodes of bacterial cystitis
• D. An 86-year-old male with a 50–pack-year cigarette smoking history

Correct answer: D

Rationale: The correct answer is D. The greatest risk factor for bladder cancer is a long history of tobacco use, which is reflected in an 86-year-old male with a 50–pack-year cigarette smoking history. Smoking is a well-established risk factor for developing bladder cancer. Choices A, B, and C are not directly linked to an increased risk of bladder cancer. While sexually transmitted diseases, certain occupational exposures, and recurrent urinary tract infections may pose other health risks, they are not specifically associated with an elevated risk of bladder cancer.

5. A client taking furosemide (Lasix) reports difficulty sleeping. What question is important for the nurse to ask the client?

• A. What dose of medication are you taking?
• B. Are you eating foods rich in potassium?
• C. Have you lost weight recently?
• D. At what time do you take your medication?

Correct answer: D

Rationale: The nurse needs to determine at what time of day the client takes the Lasix. Due to the diuretic effect of Lasix, clients should take the medication in the morning to prevent nocturia, which may be contributing to the sleep difficulties. Asking about the dose of medication (Choice A) is important but addressing the timing of intake is more crucial in this situation. Inquiring about potassium-rich foods (Choice B) is relevant for clients on potassium-sparing diuretics. Weight loss (Choice C) may be relevant for monitoring the client's overall health but is not directly related to the sleep issue in this case.

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