Nursing Elites

1. Which of the following factors can impact an individual's ability to give informed consent?

• A. IQ
• B. educational level
• C. pain medications
• D. financial status

Correct answer: C

Rationale: Pain medications might alter alertness, thought processes, and reactions, potentially impacting an individual's ability to give informed consent. It is recommended to approach a client for consent at least 4 hours after the last dose of pain medicine to minimize any influence. Choices A, B, and D are incorrect. While IQ and educational level may affect how information is presented during the discussion process, they do not directly impact informed-consent decision-making. Financial status is also not a direct factor in an individual's ability to provide informed consent, unlike pain medications which can directly affect cognitive functions and decision-making abilities.

2. A teenage client is admitted to the hospital because of an acetaminophen (Tylenol) overdose. Overdoses of acetaminophen can precipitate life-threatening abnormalities in which of the following organs?

• A. lungs
• B. liver
• C. kidneys
• D. adrenal glands

Correct answer: B

Rationale: Acetaminophen is extensively metabolized in the liver. An acetaminophen overdose can lead to severe liver damage and even liver failure, which can be life-threatening. Choices A, C, and D are incorrect. Acetaminophen overdose does not typically cause life-threatening problems in the lungs, kidneys, or adrenal glands. While prolonged acetaminophen use may increase the risk of renal dysfunction, a single overdose primarily affects the liver.

3. A mother has just given birth to a baby who died soon after. The mother has been crying and states, "I can't believe this has happened to me. I did everything right during this pregnancy."? How should the nurse respond to this mother?

• A. Tell her she did nothing wrong; it was God's will.
• B. Tell her she can have another baby.
• C. Tell her that her behavior is not going to solve anything.
• D. Tell her nothing and let her mourn this loss in the manner she chooses.

Correct answer: D

Rationale: Perinatal loss is a significant tragedy for parents, and it is crucial to provide sensitive and compassionate care. When a mother expresses her disbelief and feelings of doing everything right during the pregnancy, it is important for the nurse to acknowledge her pain and allow her to grieve in her way. Telling her that she did nothing wrong and it was God's will (Choice A) may not be comforting and can come across as dismissive of her feelings. Suggesting she can have another baby (Choice B) is insensitive and overlooks the grief she is experiencing for the current loss. Telling her that her behavior is not going to solve anything (Choice C) is invalidating her emotions and not supportive in this situation. Therefore, the best approach is to support her in her mourning process by respecting her feelings and allowing her to express her grief as she sees fit.

4. Which of the following clients should refrain from therapy with the thiazide diuretic hydrochlorothiazide?

• A. a client with renal impairment
• B. a client with hypertension
• C. a client with diabetes mellitus, type II
• D. a client with renal calculi (kidney stones)

Correct answer: C

Rationale: The correct answer is a client with diabetes mellitus, type II. Thiazide diuretics like hydrochlorothiazide can cause metabolic abnormalities, including elevated blood glucose levels. This increase is linked to diuretic-induced potassium deficiency, which reduces insulin secretion, leading to higher plasma glucose levels. Thiazides are commonly used in clients with renal impairment and hypertension. Moreover, thiazides decrease calcium excretion, reducing the risk of renal calculi, so it is not contraindicated for clients with kidney stones. Therefore, clients with diabetes mellitus, type II should avoid therapy with hydrochlorothiazide due to the potential adverse effects on blood glucose levels.

5. A client is given an opiate drug for pain relief following general anesthesia. The client becomes extremely somnolent with respiratory depression. The physician is likely to order the administration of:

• A. naloxone (Narcan).
• B. labetalol (Normodyne).
• C. neostigmine (Prostigmin).
• D. thiothixene (Navane).

Correct answer: A

Rationale: When a client becomes extremely somnolent with respiratory depression after being given an opiate drug, the physician is likely to order the administration of naloxone (Narcan). Naloxone is an opiate antagonist that attaches to opiate receptors, blocking or reversing the action of narcotic analgesics. Choices B, C, and D are incorrect. Labetalol is a beta blocker used for hypertension, neostigmine is an anticholinesterase agent used to treat myasthenia gravis and reverse neuromuscular blockade, and thiothixene is an antipsychotic agent used for psychiatric conditions.

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