Nursing Elites

1. When should surgical correction of hypospadias typically occur for a newborn infant as advised by the nurse?

• A. Repair should be done within one month to prevent bladder infections.
• B. Repairs should typically be done before the child is potty-trained.
• C. Delaying the repair until school age reduces castration fears.
• D. To form a proper urethra repair, it should be done after sexual maturity.

Correct answer: B

Rationale: Surgical repair of hypospadias is recommended to be performed before the child is potty-trained to prevent complications. Early correction helps in achieving better outcomes and reduces the risk of issues related to urination and development of the genitalia.

2. A patient with heart failure is prescribed digoxin. What is the most important instruction the nurse should provide?

• A. Take an extra dose if you miss one.
• B. Avoid high-potassium foods.
• C. Report any visual disturbances.
• D. Stop taking the medication if your pulse is normal.

Correct answer: C

Rationale: The correct answer is C: 'Report any visual disturbances.' Patients taking digoxin should be instructed to report any visual disturbances, as this can be a sign of digoxin toxicity. Visual disturbances like changes in color vision, blurred vision, or seeing halos around lights can indicate an overdose of digoxin. Choices A, B, and D are incorrect. Instructing a patient to take an extra dose if they miss one can lead to overdose. Avoiding high-potassium foods is important for patients on potassium-sparing diuretics, not digoxin. Stopping the medication if the pulse is normal is incorrect, as the pulse rate alone is not an indicator of digoxin effectiveness or toxicity.

3. A client has been diagnosed with an esophageal diverticulum after undergoing diagnostic imaging. When taking the health history, the nurse should expect the client to describe what sign or symptom?

• A. Burning pain on swallowing
• B. Regurgitation of undigested food
• C. Symptoms mimicking a myocardial infarction
• D. Chronic parotid abscesses

Correct answer: B

Rationale: Regurgitation of undigested food is a typical symptom of esophageal diverticulum. This condition forms a pouch in the esophagus that can trap food, leading to regurgitation of undigested food. The other options are not typically associated with esophageal diverticulum.

4. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen therapy. Which instruction should the nurse provide?

• A. Use oxygen continuously, even while sleeping.
• B. Adjust the oxygen flow rate to 5 liters per minute if short of breath.
• C. Report any signs of difficulty breathing immediately.
• D. Take off the oxygen while eating or drinking.

Correct answer: A

Rationale: The correct instruction for a client with COPD receiving oxygen therapy is to use oxygen continuously, even while sleeping. This is important to ensure adequate oxygenation and optimal respiratory function for clients with COPD. Continuous oxygen therapy helps maintain oxygen levels during sleep, which is crucial for individuals with COPD who may experience nighttime hypoxemia. Therefore, advising the client to use oxygen continuously, even during sleep, is essential in managing COPD and preventing complications associated with oxygen deprivation.

5. A recently widowed middle-aged female client presents to the psychiatric clinic for evaluation and tells the nurse that she has 'little reason to live.' She describes one previous suicidal gesture and admits to having a gun in her home. To maintain the client's confidentiality and to help ensure her safety, which action is best for the nurse to implement?

• A. Encourage the client to remove the gun from her possession.
• B. Notify the client's healthcare provider of the availability of the weapon.
• C. Contact a person of the client's choosing to remove the weapon from the home.
• D. Call the local police department and have the weapon removed from the home.

Correct answer: C

Rationale: In this scenario, it is crucial to maintain the client's confidentiality while ensuring her safety. Contacting a person chosen by the client to remove the weapon from her home is the best course of action. This approach respects the client's autonomy and helps reduce the risk of harm without involving external authorities unnecessarily.

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