Nursing Elites

1. The nurse is caring for the client one day postoperative sigmoid colostomy operation. Which independent nursing intervention should the nurse implement?

• A. Change the infusion rate of the intravenous fluid
• B. Encourage the client to discuss his or her feelings
• C. Administer opioid narcotic medications for pain management
• D. Assist the client out of bed to sit in the chair twice daily

Correct answer: D

Rationale: Assisting the client to sit in a chair is an essential nursing intervention postoperatively as it helps promote circulation, prevent complications like blood clots, and aids in the recovery process. Changing the infusion rate of intravenous fluid (Choice A) requires a physician's order and is not an independent nursing intervention. Encouraging the client to discuss feelings (Choice B) is important for emotional support but not as crucial as physical care immediately postoperatively. Administering opioid narcotic medications (Choice C) for pain management should be based on a prescribed schedule and assessment rather than being an independent nursing action.

2. A client with a diagnosis of catatonic schizophrenia is expected to exhibit which clinical finding?

• A. Crying
• B. Self-mutilation
• C. Immobile posturing
• D. Repetitious activities

Correct answer: C

Rationale: In catatonic schizophrenia, immobile posturing is a common clinical finding where the patient may maintain a rigid or bizarre posture for prolonged periods. Crying (Choice A) is not typically associated with catatonic schizophrenia. Self-mutilation (Choice B) is more commonly seen in conditions like borderline personality disorder. Repetitious activities (Choice D) are not a hallmark symptom of catatonic schizophrenia.

3. A client is ordered lisinopril (Zestril) for the treatment of hypertension. He asks the nurse about possible adverse effects. The nurse should inform him about which common adverse effects of angiotensin-converting enzyme (ACE) inhibitors?

• A. Constipation
• B. Dizziness
• C. Headache
• D. B, C

Correct answer: D

Rationale: The correct answer is D: 'B, C.' Dizziness and headache are common side effects of ACE inhibitors due to their blood pressure-lowering effects. Constipation is not a common adverse effect associated with ACE inhibitors, so choice A is incorrect. Choice B (Dizziness) and choice C (Headache) are more commonly seen and are directly related to the mechanism of action of ACE inhibitors, making them the correct choices.

4. A patient with a history of peptic ulcer disease should avoid which medication?

• A. Acetaminophen
• B. Antacids
• C. Nonsteroidal anti-inflammatory drugs
• D. Antihistamines

Correct answer: C

Rationale: Patients with a history of peptic ulcer disease should avoid nonsteroidal anti-inflammatory drugs (NSAIDs) because they can worsen peptic ulcers. NSAIDs inhibit the production of prostaglandins, which help protect the stomach lining. Acetaminophen (Choice A) is a safer alternative for pain relief in patients with peptic ulcers. Antacids (Choice B) can actually help in symptom relief by neutralizing stomach acid. Antihistamines (Choice D) are not known to worsen peptic ulcers and are generally safe for use in patients with this condition.

5. Which risk factor would the nurse expect to find in the client diagnosed with pancreatic cancer?

• A. Chewing tobacco
• B. Low-fat diet
• C. Chronic alcoholism
• D. Exposure to industrial chemicals

Correct answer: C

Rationale: The correct answer is chronic alcoholism. Chronic alcoholism is a significant risk factor for pancreatic cancer due to its impact on the pancreas. Chewing tobacco (choice A) is more associated with oral and throat cancers, not pancreatic cancer. A low-fat diet (choice B) is actually considered a protective factor against pancreatic cancer. Exposure to industrial chemicals (choice D) may be a risk factor for other types of cancer but is not strongly linked to pancreatic cancer.

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