Nursing Elites

1. Which of the following is the best position for a patient experiencing dyspnea?

• A. Supine position.
• B. Fowler's position.
• C. Trendelenburg position.
• D. Lateral recumbent position.

Correct answer: B

Rationale: Fowler's position is the best position for a patient experiencing dyspnea. This position involves sitting the patient upright with the head of the bed elevated between 45-60 degrees. Fowler's position helps improve breathing in patients with dyspnea by promoting lung expansion, aiding in better oxygenation, and reducing the work of breathing. The supine position (Choice A) may worsen dyspnea by limiting lung expansion. The Trendelenburg position (Choice C) with the feet elevated and the head down is not recommended for dyspnea as it can increase pressure on the chest and compromise breathing. The lateral recumbent position (Choice D) is not ideal for dyspnea as it does not provide optimal lung expansion and may not alleviate breathing difficulty.

2. A client presents with a urine specific gravity of 1.018. What action should the nurse take?

• A. Evaluate the client’s intake and output for the past 24 hours.
• B. Document the finding in the chart and continue to monitor.
• C. Obtain a specimen for a urine culture and sensitivity.
• D. Encourage the client to drink more fluids, especially water.

Correct answer: B

Rationale: A urine specific gravity of 1.018 falls within the normal range, indicating adequate hydration. Therefore, the appropriate action is to document this finding in the client's chart and continue monitoring. There is no need to evaluate intake and output, as the specific gravity is normal. Obtaining a urine culture and sensitivity or encouraging increased fluid intake is unnecessary in this situation.

3. The nurse is caring for five clients on the medical-surgical unit. Which clients would the nurse consider to be at risk for post-renal acute kidney injury (AKI)? (Select all that apply.)

• A. Man with prostate cancer
• B. Woman with blood clots in the urinary tract
• C. Client with ureterolithiasis
• D. All of the above

Correct answer: D

Rationale: Post-renal acute kidney injury (AKI) occurs due to urine flow obstruction, which can result from conditions such as prostate cancer, blood clots in the urinary tract, and ureterolithiasis (kidney stones). Severe burns would lead to pre-renal AKI by reducing blood flow to the kidneys. Lupus would cause intrarenal AKI by affecting the kidney tissue directly. Therefore, options A, B, and C are correct choices for clients at risk for post-renal AKI, making option D the correct answer.

4. A client is returning home after arthroscopy of the shoulder. The nurse should tell the client:

• A. To resume full activity the next day
• B. Not to eat or drink anything until the next morning
• C. To keep the shoulder completely immobilized for the rest of the day
• D. To report to the physician the development of fever or redness and heat at the site

Correct answer: D

Rationale: After arthroscopy, it is important for the client to report any signs of infection, such as the development of fever or redness and heat at the site, to the physician promptly. Options A, B, and C are incorrect. The client should not resume full activity the next day as rest and limited movement are usually recommended post-arthroscopy. It is not necessary to withhold food or fluids until the next morning; the client may resume the usual diet immediately unless otherwise instructed. While immobilization may be recommended for a period, keeping the shoulder completely immobilized for the rest of the day is not typically necessary post-arthroscopy.

5. Assessment of the diabetic client for common complications should include examination of the:

• A. Abdomen.
• B. Lymph glands.
• C. Pharynx.
• D. Eyes.

Correct answer: D

Rationale: The correct answer is D: Eyes. Diabetic clients are at high risk of developing complications such as diabetic retinopathy, making regular eye examinations crucial. Assessing the eyes helps in early detection and management of diabetic eye diseases. Choices A, B, and C are incorrect because while they may be relevant in certain assessments, they are not commonly associated with complications specific to diabetes. Examination of the abdomen, lymph glands, and pharynx are not typically part of routine assessments for common complications in diabetic clients.

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