Nursing Elites

1. What is the proper technique for obtaining a blood specimen from a central venous line?

• A. Use sterile gloves and discard the first 10 mL of blood
• B. Flush the line with heparin and then draw the specimen
• C. Draw the specimen and then administer heparin
• D. Use non-sterile gloves to reduce contamination risk

Correct answer: A

Rationale: The correct technique for obtaining a blood specimen from a central venous line is to use sterile gloves and discard the first 10 mL of blood. This practice helps ensure that the blood sample collected is not contaminated. Choice B is incorrect because flushing the line with heparin before drawing the specimen can contaminate the sample. Choice C is incorrect as administering heparin before drawing the specimen can affect the accuracy of the blood sample. Choice D is incorrect as using non-sterile gloves increases the risk of contamination, which is not recommended when obtaining a blood specimen from a central venous line.

2. A nurse is caring for a client post-op with a chest tube. What should the nurse check for regularly?

• A. Ensure the chest tube is periodically clamped
• B. Check for air leaks in the tubing
• C. Keep the client in a prone position for chest drainage
• D. Administer diuretics to prevent fluid buildup

Correct answer: B

Rationale: The correct answer is to check for air leaks in the tubing. Air leaks can compromise the function of the chest tube, leading to inadequate drainage and potentially causing complications for the client. Clamping the chest tube periodically is incorrect as it could lead to a buildup of fluid or air in the pleural space. Keeping the client in a prone position is not necessary for chest drainage, as the positioning may vary depending on the specific situation. Administering diuretics may not be directly related to monitoring the chest tube for proper function and is not a routine intervention for chest tube management post-op.

3. What are the complications of untreated hypertension?

• A. Heart disease and stroke
• B. Kidney failure and vision loss
• C. Pulmonary embolism and arrhythmias
• D. Blood clots and gastrointestinal bleeding

Correct answer: A

Rationale: The correct answer is A: 'Heart disease and stroke.' Untreated hypertension can lead to various complications, including heart disease and stroke. These are common outcomes of long-term high blood pressure. Choice B, 'Kidney failure and vision loss,' is incorrect as kidney failure and vision loss are more commonly associated with diabetic complications rather than untreated hypertension. Choice C, 'Pulmonary embolism and arrhythmias,' while serious, are not among the primary complications of untreated hypertension. Choice D, 'Blood clots and gastrointestinal bleeding,' are not typical complications of untreated hypertension but can occur due to other conditions such as blood clotting disorders or gastrointestinal diseases.

4. A nurse is reviewing the medical record of a client with dementia who frequently becomes agitated. What should the nurse prioritize?

• A. Investigate the client's fluid and electrolyte balance
• B. Investigate the client's recent medication changes
• C. Investigate recent changes in cognitive functioning
• D. Investigate the client's psychosocial environment

Correct answer: B

Rationale: The correct answer is to investigate the client's recent medication changes. In a client with dementia who frequently becomes agitated, medication changes can often be a significant factor contributing to their behavior. Checking recent medication changes can help identify if any specific medication is causing or exacerbating the agitation. Choice A about fluid and electrolyte balance is less likely to be the priority unless there are specific indications in the medical record. Choice C, investigating recent changes in cognitive functioning, may be important but addressing the agitation first is a more immediate concern. Choice D, investigating the client's psychosocial environment, is also important but may not directly address the immediate cause of the agitation as medication changes could.

5. A nurse is assessing the remote memory of an older adult client who has mild dementia. Which of the following questions should the nurse ask the client?

• A. Can you tell me who visited you today?
• B. What high school did you graduate from?
• C. Can you list your current medications?
• D. What did you have for breakfast yesterday?

Correct answer: B

Rationale: The correct answer is B: 'What high school did you graduate from?' Remote memory involves recalling past events, such as educational history, making option B the most appropriate question to assess this aspect of memory in an older adult with mild dementia. Option A pertains to recent memory. Option C focuses on short-term memory. Option D addresses recent memory as well.

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