Nursing Elites

1. A 45-year-old client is admitted with new-onset status epilepticus. What is the priority nursing intervention?

• A. Administer IV fluids and monitor electrolytes.
• B. Administer antiepileptic medications as prescribed.
• C. Ensure a patent airway and prepare for possible intubation.
• D. Monitor the client for signs of hypotension.

Correct answer: C

Rationale: The correct answer is C. In a client with new-onset status epilepticus, the priority nursing intervention is to ensure a patent airway and prepare for possible intubation. This is crucial to prevent hypoxia and further complications. Administering IV fluids and monitoring electrolytes (choice A) can be important but ensuring airway patency takes precedence. Administering antiepileptic medications (choice B) is essential but only after securing the airway. Monitoring for hypotension (choice D) is also important but not the priority when managing status epilepticus.

2. A patient is prescribed tadalafil (Cialis) for erectile dysfunction. What condition would contraindicate the use of this medication?

• A. History of hypertension
• B. Use of nitrates
• C. Use of antihypertensive medications
• D. History of peptic ulcer disease

Correct answer: B

Rationale: The correct answer is B: 'Use of nitrates.' Tadalafil (Cialis) is contraindicated in patients using nitrates due to the risk of severe hypotension. Nitrates and tadalafil both cause vasodilation, leading to a synergistic effect that can result in a dangerous drop in blood pressure. Choices A, C, and D are incorrect because a history of hypertension, the use of antihypertensive medications, and a history of peptic ulcer disease are not direct contraindications for tadalafil use.

3. After a generalized seizure, a 27-year-old woman with epilepsy feels tired and falls asleep. This is:

• A. an ominous sign.
• B. normal and termed the postictal period.
• C. a reflection of an underlying brain tumor.
• D. only worrisome if there are focal neurologic deficits after.

Correct answer: B

Rationale: Choice B is the correct answer. The postictal period is the phase following a seizure, characterized by symptoms like fatigue, confusion, and sleepiness. It is a normal part of the seizure process and does not necessarily indicate a serious underlying issue. Choice A is incorrect because feeling tired and falling asleep after a seizure is expected and not an ominous sign. Choice C is incorrect as there is no indication in the scenario provided to suggest an underlying brain tumor. Choice D is incorrect because the presence of focal neurologic deficits would indeed be concerning, but the postictal state itself is a common and expected occurrence post-seizure.

4. A nurse practitioner is seeing a client in the clinic with a suspected diagnosis of bacterial meningitis. What should the nurse anticipate as the priority action?

• A. Administer the first dose of antibiotics immediately after blood cultures are drawn.
• B. Start an IV line and administer corticosteroids to reduce inflammation.
• C. Isolate the client to prevent the spread of infection.
• D. Perform a lumbar puncture to confirm the diagnosis.

Correct answer: A

Rationale: The correct answer is to administer the first dose of antibiotics immediately after blood cultures are drawn for suspected bacterial meningitis. This is crucial to initiate treatment promptly and improve patient outcomes. Starting an IV line and administering corticosteroids (Choice B) may be part of the treatment plan but administering antibiotics is the priority. Isolating the client (Choice C) is important to prevent the spread of infection but not the priority over initiating antibiotic therapy. Performing a lumbar puncture (Choice D) may confirm the diagnosis, but treatment should not be delayed for this step in suspected cases of bacterial meningitis.

5. A woman with severe visual and auditory deficits is able to identify individuals by running her fingers lightly over her face. Which source is most likely to provide the input that allows for the woman's unique ability?

• A. Special somatic afferent fibers
• B. General somatic afferents
• C. Special visceral afferent cells
• D. General visceral afferent neurons

Correct answer: C

Rationale: The correct answer is C, special visceral afferent cells. These cells are responsible for functions like taste and smell. In individuals with severe visual and auditory deficits, their other sensory abilities, such as touch, can be heightened. Special somatic afferent fibers (choice A) are involved in sensations like touch and vibration from the skin and muscles, but they are not specific to the face. General somatic afferents (choice B) transmit sensory information from the skin, muscles, and joints, but they are not specialized for the unique ability described. General visceral afferent neurons (choice D) are responsible for transmitting sensory information from internal organs, not relevant to the woman's ability to identify individuals through touch on her face.

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