Nursing Elites

1. The client is preparing a morning dose of insulin, which includes 10 units of regular and 22 units of NPH. The nurse is verifying the client's preparation accuracy. What should the syringe read for the correct dose?

• A. 22 units.
• B. 10 units.
• C. 32 units.
• D. 42 units.

Correct answer: C

Rationale: The correct answer is 32 units. To determine the correct dose, the nurse needs to add the 10 units of regular insulin to the 22 units of NPH, resulting in a total of 32 units. Therefore, the syringe should read 32 units. Choices A, B, and D are incorrect because they do not reflect the accurate total dose required for the morning insulin administration.

2. The client with chronic renal failure is receiving hemodialysis. Which of the following laboratory values should the nurse monitor closely?

• A. Hemoglobin level.
• B. Blood urea nitrogen (BUN) level.
• C. Serum potassium level.
• D. Creatinine level.

Correct answer: C

Rationale: The serum potassium level should be monitored closely in clients undergoing hemodialysis due to the risk of hyperkalemia. Hemodialysis is used to remove waste products and excess electrolytes like potassium from the blood. Monitoring potassium levels is crucial because an imbalance can lead to serious cardiac complications, making it the priority value to monitor in this scenario. Monitoring hemoglobin levels (choice A) is important for anemia assessment in chronic renal failure but is not directly related to hemodialysis. Blood urea nitrogen (BUN) levels (choice B) and creatinine levels (choice D) are commonly monitored in renal function tests but are not the top priority for monitoring in a client undergoing hemodialysis.

3. A client is being prepared for transfer to the operating room. Which of the following actions should the nurse take in the care of this client at this time?

• A. Ensuring that the client has voided
• B. Administering all daily medications
• C. Practicing postoperative breathing exercises
• D. Verifying that the client has not eaten for the last 24 hours

Correct answer: A

Rationale: The nurse should ensure that the client has voided, especially if a Foley catheter is not in place. This step is important to prevent urinary retention during the surgical procedure. Administering all daily medications just before surgery is not standard practice. The physician typically provides specific orders regarding which medications can be taken with a sip of water before surgery. Postoperative breathing exercises are usually taught after surgery to prevent complications like atelectasis. Verifying that the client has not eaten for the last 24 hours is not a standard preoperative practice; instead, the client is usually instructed to fast for a specific period before surgery to reduce the risk of aspiration during anesthesia.

4. A male client with chronic kidney disease (CKD) is refusing to take his medication and has missed two hemodialysis appointments. What is the best initial action for the nurse?

• A. Discuss what the treatment regimen means to him.
• B. Refer the client to a mental health nurse practitioner.
• C. Reschedule the appointments to another date and time.
• D. Discuss the option of peritoneal dialysis.

Correct answer: A

Rationale: The best initial action for the nurse in this scenario is to have a discussion with the client about what the treatment regimen means to him. It is important to assess the client's anxiety, coping styles, and acceptance of the required treatment for CKD. The client may be in denial of the diagnosis or may have concerns that need to be addressed. While rescheduling hemodialysis appointments could be helpful, referring the client to a mental health nurse practitioner or discussing peritoneal dialysis are not the most appropriate first steps. Understanding the client's perspective and concerns is crucial before exploring other interventions.

5. After teaching a client with bacterial cystitis who is prescribed phenazopyridine (Pyridium), the nurse assesses the client’s understanding. Which statement made by the client indicates a correct understanding of the teaching?

• A. I will not take this drug with food or milk.
• B. If I suspect pregnancy, I will discontinue the drug.
• C. An orange color in my urine should not alarm me.
• D. I will consume two glasses of cranberry juice daily.

Correct answer: C

Rationale: The correct answer is C. Phenazopyridine commonly discolors urine to a deep reddish orange, which can be mistaken for blood. It is important for the client to understand that this color change is an expected side effect and should not be a cause for alarm. Additionally, the urine can stain clothing. There are no dietary restrictions or precautions related to food or milk intake while taking phenazopyridine. Stopping the medication if suspecting pregnancy is not necessary as phenazopyridine is safe to use during pregnancy. Drinking cranberry juice is not directly related to the use of phenazopyridine and is not a specific instruction given for managing bacterial cystitis.

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