Nursing Elites

1. During the acute phase of a burn, the priority nursing intervention in caring for this client is:

• A. Prevention of infection
• B. Pain management
• C. Prevention of bleeding
• D. Fluid resuscitation

Correct answer: D

Rationale: During the acute phase of a burn, fluid resuscitation is the priority nursing intervention. This phase is characterized by fluid loss and the risk of hypovolemic shock. Administering fluids is crucial to maintain perfusion and prevent complications such as organ failure. While prevention of infection, pain management, and prevention of bleeding are important aspects of burn care, fluid resuscitation takes precedence in the acute phase to stabilize the client's condition and prevent further damage.

2. A client who is 2 days postoperative following abdominal surgery is about to progress from a clear liquid diet to full liquids. Which of the following items should the nurse tell the client he may now request to have on his meal tray?

• A. Cranberry juice
• B. Flavored gelatin
• C. Skim milk
• D. Chicken broth

Correct answer: A

Rationale: Cranberry juice is an appropriate choice for a client transitioning from a clear liquid diet to full liquids post abdominal surgery. It provides hydration and some essential nutrients. Flavored gelatin is usually allowed on a clear liquid diet and may not be suitable for a full liquids phase. Skim milk and chicken broth are typically introduced in a later stage of the diet progression, closer to a soft diet, due to their higher protein and fat content.

3. When is Prevident indicated?

• A. High caries risk
• B. Crown and bridge work
• C. Orthodontic decalcification
• D. All of the above

Correct answer: D

Rationale: Prevident is indicated for all the situations listed in the choices. It is recommended for patients with a high risk of caries to reduce the risk of tooth decay. It is also used in dental procedures like crown and bridge work to strengthen enamel and prevent cavities. Furthermore, it is utilized for orthodontic decalcification to aid in remineralizing the tooth structure and prevent further damage. Therefore, the correct answer is 'All of the above.' While choices A, B, and C are individually correct, selecting 'All of the above' is the most appropriate as it encompasses all the possible indications for Prevident.

4. Which of the following gauges should you prepare for spinal anesthesia if the anesthesiologist requires a pink spinal set and a blue spinal set as backup?

• A. Gauges 16 and 22
• B. Gauges 18 and 16
• C. Gauges 16 and 20
• D. Gauges 25 and 22

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

5. What is the initial major sign of acute renal failure?

• A. Oliguria
• B. Hematuria
• C. Proteinuria
• D. Glycosuria

Correct answer: A

Rationale: Oliguria, or reduced urine output, is often the initial major sign of acute renal failure. This reduction in urine output indicates that the kidneys are not functioning properly. Hematuria (blood in urine), proteinuria (presence of protein in urine), and glycosuria (presence of glucose in urine) are not typically the initial major signs of acute renal failure. While they may be present in certain conditions, oliguria is the most common and critical indicator of acute renal failure.

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