Nursing Elites

1. A client had a C5 spinal cord contusion that resulted in quadriplegia. Two days after the injury occurred, the nurse sees his mother crying in the waiting room. The mother asks the nurse whether her son will ever play football again. Which of the following is the best initial response?

• A. "Given time and motivation, your son may regain some function, but I will seek more information from the physician."?
• B. Maintain a calm demeanor and speech pattern while addressing the mother's concerns.
• C. "I'm not sure, but I'll call the physician to discuss this with you promptly."?
• D. "It's not beneficial for your son if you get upset."?

Correct answer: C

Rationale: The best initial response in this situation is to acknowledge the mother's concern, express uncertainty, and offer to obtain more information from the physician. By saying, "I'm not sure, but I'll call the physician to discuss this with you promptly,"? the nurse demonstrates empathy, honesty, and a commitment to providing accurate information. Offering vague reassurance (Choice A) may raise false hopes as outcomes for spinal cord injuries are unpredictable. While maintaining a calm demeanor (Choice B) is important, it does not directly address the mother's immediate need for information. Discouraging the mother from feeling upset (Choice D) is dismissive of her emotions and does not address her question, which is seeking information about her son's prognosis.

2. A healthcare professional is reviewing a patient's serum glucose levels. Which of the following scenarios would indicate abnormal serum glucose values for a 30-year-old male?

• A. 70 mg/dL
• B. 55 mg/dL
• C. 110 mg/dL
• D. 100 mg/dL

Correct answer: B

Rationale: The correct answer is 55 mg/dL. The standard range for serum glucose levels is typically 60-115 mg/dL. A serum glucose level of 55 mg/dL falls below this range, indicating hypoglycemia. Options A, C, and D are within the standard range for serum glucose levels and would not be considered abnormal for a 30-year-old male.

3. The client has been taking divalproex (Depakote) for the management of bipolar disorder. The nurse should give priority to monitoring which laboratory test?

• A. Alanine aminotransferase (ALT)
• B. Serum glucose
• C. Serum creatinine
• D. Serum electrolytes

Correct answer: A

Rationale: The correct answer is Alanine aminotransferase (ALT). Monitoring ALT levels is crucial when a patient is taking divalproex (Depakote) due to the risk of drug-induced hepatitis. Elevated ALT levels indicate liver damage or disorders, which can be a side effect of Depakote. Serum glucose (choice B) is not the priority for monitoring in this case, as the medication does not directly affect glucose levels. Serum creatinine (choice C) is not the most relevant test to monitor for Depakote use; it primarily assesses kidney function. Serum electrolytes (choice D) are important but do not take precedence over monitoring ALT levels when a patient is on Depakote.

4. A client is having psychological counseling for problems communicating with his mother. Which model of stress is the most useful in reference to this stressor?

• A. Adaptation Model
• B. Stimulus-Based Model
• C. Transaction-Based Model
• D. Selye's Model of Stress

Correct answer: C

Rationale: The Transaction-Based Model, proposed by R.S. Lazarus, is the most relevant model of stress in the context of a client facing communication issues with his mother. This model takes into consideration individual differences and cognitive processes that occur between a stressor and the individual's response. It emphasizes the importance of how the individual perceives and interprets the stressor, incorporating mental and psychological components. In this scenario, the client's difficulties in communicating with his mother involve complex cognitive processes and individual perceptions, making the Transaction-Based Model the most suitable choice. The other options are not as relevant in this context: the Adaptation Model focuses on adjustment to stress over time, the Stimulus-Based Model emphasizes external factors as stressors, and Selye's Model of Stress mainly centers on the physiological response to stress.

5. In a client with asthma who develops respiratory acidosis, what should the nurse expect the client's serum potassium level to be?

• A. normal
• B. elevated
• C. low
• D. unrelated to the pH

Correct answer: B

Rationale: In respiratory acidosis, the serum potassium level is expected to be elevated. This occurs because potassium shifts from cells into the bloodstream as a compensatory mechanism to maintain acid-base balance. Choices A, C, and D are incorrect. A normal potassium level is not expected in respiratory acidosis. A low potassium level is more commonly associated with alkalosis, not acidosis. The potassium level is indeed related to pH changes in respiratory acidosis, leading to the expected elevation.

Similar Questions