Nursing Elites

1. After a client has a tubal ligation in the outpatient surgical clinic, what is the priority for the nurse to determine?

• A. The client's prior experiences with outpatient surgery
• B. The client's medical plan and the extent of coverage for outpatient surgery
• C. The client's plan for transportation and care at home
• D. The client's plan to spend the night at the surgical center

Correct answer: C

Rationale: The priority for the nurse is to ensure the client has a safe way to get home and adequate care after discharge. It is crucial to determine the client's transportation arrangements and availability of care at home to ensure a smooth transition postoperatively. Options A and B, though important, are not immediate priorities compared to the client's safety and well-being after the procedure. Option D is incorrect as spending the night at the surgical center is not typically part of the plan for outpatient surgery.

2. The nurse is caring for a client admitted with Class III/IV Pulmonary Hypertension. The nurse explains to the client that Lanoxin is being administered to the client in order to:

• A. Manage peripheral edema
• B. Improve right ventricular function
• C. Increase pulmonary pressure
• D. Constrict the pulmonary vessels

Correct answer: B

Rationale: The correct answer is to improve right ventricular function. Lanoxin, also known as digoxin, is a cardiac glycoside that works by slowing the heart rate and increasing myocardial contractility, especially in the ventricles. This action helps improve the efficiency of the heart's pumping function, particularly the right ventricle in conditions like pulmonary hypertension. Choice A, managing peripheral edema, is not directly related to Lanoxin's mechanism of action. Choice C, increasing pulmonary pressure, is incorrect as Lanoxin is not used to increase pressure in the pulmonary circulation. Choice D, constricting the pulmonary vessels, is incorrect as Lanoxin does not cause vasoconstriction in the pulmonary vessels but rather acts on the heart's contractility.

3. On morning rounds, the nurse finds a somnolent client with a Blood glucose of 89 mg/dL. A sulfonurea and a proton pump inhibitor are scheduled to be administered. What is the nurse's best action?

• A. Give the proton pump inhibitor and hold the sulfonurea until the client eats
• B. Hold medications and notify the physician
• C. Arouse the client and give some orange juice with sugar packets added
• D. Give the medications as ordered and re-check blood sugar in one hour

Correct answer: A

Rationale: The correct action is to give the proton pump inhibitor and hold the sulfonurea until the client eats. Sulfonureas should be held for blood glucose levels below 100 mg/dL until the client has food to prevent hypoglycemia. Giving the proton pump inhibitor is appropriate and does not need to be delayed. Option B is incorrect because holding both medications without taking appropriate action may lead to further complications. Option C is not the best choice as it does not address the need to hold the sulfonurea until the client eats. Option D is incorrect because administering the medications without ensuring the client eats may lead to hypoglycemia.

4. Nurses should understand the chain of infection because it refers to:

• A. the linkages involved in disease transmission.
• B. the sequence required for transmission of disease.
• C. the clustering of bacteria in a specific pattern.
• D. increasing virulence patterns among microorganisms.

Correct answer: B

Rationale: The chain of infection refers to the sequence required for the transmission of disease, involving steps like the pathogen's presence, movement from a reservoir, and entry into a susceptible host. Understanding this sequence helps healthcare professionals, including nurses, in implementing effective infection control measures. Choices A, C, and D are incorrect because they do not accurately describe the concept of the chain of infection. Choice A is too broad and does not specifically address the sequential nature of disease transmission. Choice C focuses on bacterial clustering rather than the transmission process. Choice D mentions virulence patterns, which are not the primary focus of the chain of infection concept.

5. Which of the following medications is a serotonin antagonist that might be used to relieve nausea and vomiting?

• A. metoclopramide (Reglan)
• B. ondansetron (Zofran)
• C. hydroxyzine (Vistaril)
• D. prochlorperazine (Compazine)

Correct answer: B

Rationale: Zofran is a serotonin antagonist that can be used to relieve nausea and vomiting. Ondansetron (Zofran) works by blocking serotonin receptors in the chemoreceptor trigger zone (CTZ) and the gastrointestinal tract. This action helps reduce nausea and vomiting. Metoclopramide (Reglan) works as a dopamine antagonist and also has prokinetic effects, making it effective for different conditions. Hydroxyzine (Vistaril) is an antihistamine with antiemetic properties, but it does not act as a serotonin antagonist. Prochlorperazine (Compazine) is a dopamine antagonist that is also used to treat nausea and vomiting, but not as a serotonin antagonist like ondansetron.

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