Nursing Elites

1. Nurse Cecilia is caring for a client who has undergone a vaginal hysterectomy. The nurse avoids which of the following in the care of this client?

• A. Elevating the knee gatch on the bed
• B. Assisting with range-of-motion leg exercises
• C. Removal of antiembolism stockings twice daily
• D. Checking placement of pneumatic compression boots

Correct answer: A

Rationale: The correct answer is A. Elevating the knee gatch on the bed should be avoided in the care of a client who has undergone a vaginal hysterectomy. This action can inhibit venous return, increasing the risk of deep vein thrombosis or thrombophlebitis. Choices B, C, and D are appropriate nursing interventions for postoperative care to prevent complications and promote circulation.

2. A nurse is caring for a client admitted for Non-Hodgkin’s lymphoma and chemotherapy. The client reports nausea, flank pain, and muscle cramps. What action by the nurse is most important?

• A. Request an order for serum electrolytes and uric acid.
• B. Increase the client’s IV infusion rate.
• C. Instruct assistive personnel to strain all urine.
• D. Administer an IV antiemetic.

Correct answer: A

Rationale: The client's symptoms of nausea, flank pain, and muscle cramps are suggestive of tumor lysis syndrome (TLS), a potentially life-threatening complication of chemotherapy in which cancer cells break down rapidly, releasing large amounts of intracellular components into the bloodstream. This leads to imbalances in electrolytes (elevated potassium, phosphate, and uric acid levels, with low calcium levels), which can cause severe metabolic disturbances, including kidney damage, arrhythmias, and muscle cramps. Checking serum electrolytes and uric acid levels is crucial for diagnosing and managing TLS early, preventing further complications.

3. A nurse is caring for a patient diagnosed with essential thrombocythemia (ET) who is at risk for thromboembolic events. What nursing intervention is most appropriate for this patient?

• A. Encouraging regular physical activity
• B. Administering anticoagulant therapy
• C. Monitoring for signs of bleeding
• D. Monitoring for signs of infection

Correct answer: B

Rationale: Administering anticoagulant therapy is crucial to prevent thromboembolic events in patients with ET.

4. Which of the following is considered correct in dealing with a patient who has gastric cancer?

• A. After total gastrectomy, patient will have to increase fluids during meals
• B. After total gastrectomy, patient will need lots of fiber in the diet
• C. After total gastrectomy, patient will have to walk about after meals
• D. After total gastrectomy, patient will have to lie flat on bed after meals

Correct answer: D

Rationale: After a total gastrectomy, where the entire stomach is removed, patients can experience dumping syndrome due to the rapid passage of food into the small intestine. This condition can lead to symptoms such as nausea, vomiting, diarrhea, and abdominal cramps. Lying flat after meals can help slow down the movement of food into the intestines, reducing the risk of dumping syndrome. It's important for patients to follow dietary recommendations and positioning strategies to manage symptoms effectively.

5. A new nurse has been assigned a client who is in the hospital to receive iodine-131 treatment. Which action by the nurse is best?

• A. Ensure the client is placed in protective isolation.
• B. Have pregnant visitors stay 6 feet from the client.
• C. No special action is necessary to care for this client.
• D. Read the policy on handling radioactive excreta.

Correct answer: D

Rationale: Handling radioactive excreta requires special precautions; the nurse must be familiar with the facility's policies.

Similar Questions