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A nurse is assessing a patient with frequent diarrhea. Which finding would be the greatest concern and require prompt intervention?
Dehydration
Decreased skin turgor
Dry mucous membranes with thick saliva
Increased thirst
Correct Answer:
A. Dehydration
Explanation of Correct Answer
The most concerning complication of diarrhea is dehydration, which can quickly develop due to excessive fluid loss. Dehydration can lead to electrolyte imbalance, hypovolemia, and impaired organ function if not corrected promptly. While decreased skin turgor, dry mucous membranes, and increased thirst are all signs of dehydration, the overall condition of dehydration itself represents the most urgent clinical concern requiring immediate management.
A client complains about the taste of the sublingual nitroglycerin and admits that he swallows it rather than holding it under his tongue. The nurse explains that sublingual medications:
can be taken between the cheek and tongue to diminish taste
can be held against the roof of the mouth with the tongue to reduce taste.
should not be swallowed because it alters the absorption potential
can be inserted rectally without loss of absorption potential
Correct Answer:
C. should not be swallowed because it alters the absorption potential.
Explanation of Correct Answer
Sublingual medications, such as nitroglycerin, are designed to dissolve under the tongue, where they are absorbed rapidly into the bloodstream through the oral mucosa. Swallowing the medication subjects it to first-pass metabolism in the liver, which reduces its bioavailability and effectiveness. Therefore, clients should be instructed never to swallow sublingual tablets, as doing so alters absorption and delays therapeutic action.
A nurse is preparing to insert a urinary catheter for an older male patient who has a large abdominal dressing in place. Which type of catheter would be most appropriate?
Suprapubic catheter
Straight catheter
Condom catheter
Indwelling Foley catheter
Correct Answer:
C. Condom catheter
Explanation of Correct Answer
For an older male patient with an abdominal dressing, a condom catheter is the best option because it is external, non-invasive, and avoids disturbing the abdominal site. It reduces the risk of infection compared to an indwelling catheter and provides a safe way to manage urine collection without interfering with wound care or applying additional pressure to the abdomen.
A nurse is collecting a social history from a patient and learns the patient lives in an egalitarian household. How should the nurse understand this type of household?
One spouse holds authority over all major decisions
Children have primary responsibility for decision-making
Extended family elders control household rules
Spouses share responsibilities and decision-making equally
Correct Answer:
D. Spouses share responsibilities and decision-making equally
Explanation of Correct Answer
An egalitarian household is one in which both spouses share responsibilities, authority, and decision-making equally. Neither partner dominates; instead, household duties, financial management, and family roles are balanced. This approach emphasizes equality and cooperation, supporting mutual respect between partners. In contrast, patriarchal or matriarchal households designate one partner as the primary authority figure.
A nurse is caring for a patient who has just returned from a bronchoscopy. What precaution should the nurse take to protect the patient?
Encourage fluids immediately to clear secretions
Have the patient not eat or drink for 2 hours or until the gag reflex returns
Position the patient flat to promote airway rest
Provide a regular diet as soon as the patient is awake
Correct Answer:
B. Have the patient not eat or drink for 2 hours or until the gag reflex returns
Explanation of Correct Answer
After bronchoscopy, the throat and gag reflex are temporarily suppressed due to local anesthesia. Allowing the patient to eat or drink before the gag reflex returns increases the risk of aspiration. The nurse should keep the patient NPO for about 2 hours or until the gag reflex is confirmed to have returned, ensuring airway protection and patient safety.
A nurse is assessing a patient with a new ileostomy. Which finding would be most concerning and require immediate intervention?
Stool that is liquid in consistency
A stoma that is pink and moist
Intraoperative manipulation of the anal canal
A stoma that appears pale, dusky, or black
Correct Answer:
D. A stoma that appears pale, dusky, or black
Explanation of Correct Answer
In a patient with an ileostomy, the most concerning finding is a stoma that is pale, dusky, or black in color, as this indicates impaired blood flow and possible tissue necrosis. A healthy stoma should appear pink to red and moist, reflecting good perfusion. Immediate intervention is needed to prevent ischemia and serious complications. In contrast, liquid stool and a pink moist stoma are expected findings, while intraoperative manipulation of the anal canal is not a typical concern postoperatively.
A nurse is attending a workshop on providing culturally competent care. How is cultural sensitivity best defined?
Learning only the language of another culture to improve communication
Avoiding all discussions about cultural beliefs with patients
The ability to engage and communicate with an individual from another culture in a manner that demonstrates respect for their cultural norms and beliefs
Expecting patients to adapt fully to the nurse’s cultural practices
Correct Answer:
C. The ability to engage and communicate with an individual from another culture in a manner that demonstrates respect for their cultural norms and beliefs
Explanation of Correct Answer
Cultural sensitivity means being aware of and respectful toward cultural differences, values, and practices when interacting with others. It requires effective communication that acknowledges and honors cultural norms rather than imposing one’s own. By practicing cultural sensitivity, nurses build trust, reduce misunderstandings, and deliver care that is inclusive and supportive of diverse cultural backgrounds.
A nurse is caring for a patient receiving continuous tube feeding. What should the nurse do to avoid complications?
Increase the feeding rate if the patient complains of hunger
Monitor frequently for constipation, nausea, diarrhea, hyperglycemia, and electrolyte imbalance
Administer all medications at once through the feeding tube without flushing
Stop checking residual volumes once feeding is established
Correct Answer:
B. Monitor frequently for constipation, nausea, diarrhea, hyperglycemia, and electrolyte imbalance
Explanation of Correct Answer
To avoid complications of continuous tube feeding, the nurse must monitor the patient frequently for gastrointestinal issues such as constipation, nausea, and diarrhea, as well as metabolic problems like hyperglycemia and electrolyte imbalance. Continuous monitoring allows for early detection of feeding intolerance or complications, enabling prompt intervention. Proper flushing, medication administration, and monitoring residuals are also key parts of safe tube feeding management.
A nurse is providing dietary teaching to a patient with a new colostomy. The nurse explains that which foods can increase the risk of obstruction in a colostomy?
Bananas, rice, and applesauce
Popcorn, nuts, coconut, and raw fruits with seeds
White bread, eggs, and lean chicken
Yogurt, oatmeal, and cooked carrots
Correct Answer:
B. Popcorn, nuts, coconut, and raw fruits with seeds
Explanation of Correct Answer
Certain foods are difficult to digest and may increase the risk of blockage in a colostomy. These include popcorn, Chinese vegetables, raw fruits, pineapple, kernel corn, celery, tomatoes, nuts, coconuts, fruits with seeds, tough meats, shrimp, and lobster. Such foods can lodge in the stoma opening, obstructing output. Patients should be taught to avoid or carefully chew these foods to reduce the risk of complications.
A nurse is attending a cultural competence seminar and hears the term ethnocentrism. How should the nurse understand this concept?
The belief that all cultures are equally valid and should be respected
The belief that one’s own cultural group determines the standards by which other groups’ behavior should be judged
The ability to adapt to different cultural practices without judgment
The process of blending aspects of multiple cultures into one’s lifestyle
Correct Answer:
B. The belief that one’s own cultural group determines the standards by which other groups’ behavior should be judged
Explanation of Correct Answer
Ethnocentrism is the belief that one’s own culture is superior and that its values, customs, and practices are the standard for judging other cultures. This viewpoint can create bias, prejudice, and misunderstandings in healthcare settings. Recognizing ethnocentrism helps nurses avoid imposing personal cultural norms on patients, instead fostering cultural sensitivity and delivering care that respects diverse beliefs and practices.
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