Nursing Elites

1. Which of the following is an example of intrapersonal conflict?

• A. A nurse feels guilty when she administers essential medication that causes a client to have nausea and vomiting
• B. A nurse is called to testify in court about a client she cared for three years ago
• C. A nurse feels guilty for working overtime
• D. A nurse faces a conflict with a colleague over patient care decisions

Correct answer: A

Rationale: Intrapersonal conflict involves negative feelings or frustrations within oneself. It may be related to decisions or actions that clash with personal morals or beliefs. Choice A is the correct answer because the nurse is experiencing guilt due to administering medication that causes a client to have negative side effects, which reflects an internal struggle. Choices B, C, and D do not represent intrapersonal conflict. Choice B involves a legal obligation, Choice C is related to external factors like working overtime, and Choice D pertains to a conflict with a colleague.

2. A client is discharged following hospitalization for congestive heart failure. The nurse teaching the family suggests they encourage the client to rest frequently in which of the following positions?

• A. High Fowler's
• B. Supine
• C. Left lateral
• D. Low Fowler's

Correct answer: A

Rationale: The correct answer is "High Fowler's" position. Sitting in a chair or resting in a bed in a high Fowler's position decreases the cardiac workload and facilitates breathing. This position helps reduce the work of breathing and promotes optimal lung expansion, making it easier for the client to breathe. Supine position (choice B) is lying flat on the back and may not be ideal for clients with congestive heart failure as it can increase pressure on the heart. Left lateral position (choice C) is commonly used for promoting circulation in clients with certain conditions but is not the most appropriate for congestive heart failure. Low Fowler's position (choice D) is not recommended as it does not provide the same benefits in terms of reducing cardiac workload and easing breathing as the high Fowler's position.

3. The clinic nurse teaches a patient with a 42 pack-year history of cigarette smoking about lung disease. Which information will be most important for the nurse to include?

• A. Options for smoking cessation
• B. Reasons for annual sputum cytology testing
• C. Erlotinib (Tarceva) therapy to prevent tumor risk
• D. Computed tomography (CT) screening for lung cancer

Correct answer: A

Rationale: The most critical information for the nurse to provide to a patient with a significant smoking history is options for smoking cessation. Smoking is the primary cause of lung cancer, making smoking cessation essential in reducing the risk of developing the disease. Annual sputum cytology testing is not a standard screening test for lung cancer; instead, CT scanning is being explored for this purpose. Erlotinib therapy is used in lung cancer treatment but not for preventing tumor risk in individuals without cancer. CT screening for lung cancer is still under investigation and is not primarily aimed at prevention but rather early detection in high-risk individuals.

4. A client is having blood tests and has an elevated lymphocyte level. Based on knowledge of cellular components, what does the nurse know about these cells?

• A. Contain histamine and provide protection during allergic reactions
• B. Are involved in phagocytosis
• C. Provide protection and immunity against foreign substances
• D. Carry hemoglobin and oxygen to body tissues

Correct answer: C

Rationale: Lymphocytes are a type of white blood cells that play a crucial role in supporting the body's immune system. They are responsible for producing substances that protect the body against infections and foreign substances that could potentially harm the client. Lymphocytes consist of two main types: T cells, which are produced in the thymus, and B cells, which are produced in the lymphatic tissue. Choice A is incorrect because histamine is mainly associated with basophils and mast cells, not lymphocytes. Choice B is incorrect as phagocytosis is a function of other white blood cells such as neutrophils and macrophages. Choice D is also incorrect as carrying hemoglobin and oxygen is a function of red blood cells, not lymphocytes.

5. As you are assessing the fetus during labor, you are determining the fetal lie, presentation, attitude, station, and position. Your client asks you what all these assessments are. Among other things, how should you respond to the mother?

• A. You should explain that fetal lie is where the fetus's presenting part is within the birth canal during labor, among other information about the other assessments.
• B. You should explain that fetal presentation is the relationship of the fetus's spine to the mother's spine, among other information about the other assessments.
• C. You should explain that fetal attitude is the relationship of the fetus's presenting part to the anterior, posterior, right, or left side of the mother's pelvis, among other information about the other assessments.
• D. You should explain that fetal station is the level of the fetus's presenting part in relationship to the mother's ischial spines, among other information about the other assessments.

Correct answer: D

Rationale: You should explain that fetal station is the level of the fetus's presenting part in relationship to the mother's ischial spines. Fetal station is measured in terms of the number of centimeters above or below the mother's ischial spines. When the fetus is 1 to 5 centimeters above the ischial spines, the fetal station is -1 to -5, and when the fetus is 1 to 5 centimeters below the level of the maternal ischial spines, the fetal station is +1 to +5. Choices A, B, and C provide incorrect information about fetal lie, presentation, and attitude, respectively, which do not align with the definitions of these terms in obstetrics.

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