Nursing Elites

1. A client on an acute medicine unit of a hospital with a diagnosis of small bowel obstruction is reporting intense, diffuse pain in her abdomen. Which physiologic phenomenon is most likely contributing to her complaint?

• A. Somatic pain resulting from pressure on the parietal peritoneum
• B. Referred pain from her small bowel
• C. Visceral pain resulting from distension and ischemia
• D. Neuropathic pain resulting from autonomic dysfunction

Correct answer: C

Rationale: Visceral pain is associated with distension, ischemia, and inflammation of internal organs. In the case of a small bowel obstruction, the intense, diffuse pain reported by the client is likely due to the distension and ischemia of the small bowel. Somatic pain (Choice A) would be more localized and sharp, typically arising from the parietal peritoneum. Referred pain (Choice B) is pain perceived at a site distant from the actual pathology. Neuropathic pain (Choice D) involves dysfunction or damage to the nervous system and is not typically associated with the described physiologic phenomenon of distension and ischemia in the context of a small bowel obstruction.

2. A 50-year-old woman has had a relapse of her multiple sclerosis (MS) after several years of being symptom-free. Which of the following factors is most likely to have contributed to her relapse?

• A. Emotional stress
• B. Dietary indiscretion
• C. Physical overexertion
• D. Adequate rest and relaxation

Correct answer: C

Rationale: The correct answer is C: Physical overexertion. In individuals with multiple sclerosis (MS), physical overexertion can exacerbate symptoms and contribute to a relapse. It is important for individuals with MS to balance physical activity to avoid triggering symptom reoccurrence. Choices A, B, and D are less likely to have directly contributed to the relapse. Emotional stress and dietary indiscretion may play a role in exacerbating symptoms in some individuals, but physical overexertion is more commonly associated with MS relapses. Adequate rest and relaxation are important for overall well-being but are not typically linked to MS relapses.

3. A client with chronic obstructive pulmonary disease (COPD) is admitted to the hospital for pneumonia. Which intervention should the nurse prioritize?

• A. Administer bronchodilators as prescribed.
• B. Monitor oxygen saturation levels continuously.
• C. Administer intravenous antibiotics as prescribed.
• D. Provide respiratory therapy treatments as needed.

Correct answer: C

Rationale: Administering IV antibiotics is crucial for treating pneumonia in a client with COPD. Pneumonia is an infection of the lungs that requires prompt antibiotic therapy to prevent complications and improve outcomes. While bronchodilators may help with COPD symptoms, in the case of pneumonia, addressing the infection is the priority. Continuous monitoring of oxygen saturation is important, but administering antibiotics to treat the underlying infection takes precedence. Respiratory therapy treatments can be beneficial, but they are not the initial priority when managing pneumonia in a client with COPD.

4. What is the primary role of albumin in the blood?

• A. Transport oxygen throughout the body.
• B. Serve as a key clotting factor.
• C. Maintain osmotic pressure and fluid balance.
• D. Act as an immune response molecule.

Correct answer: C

Rationale: The correct answer is C: Maintain osmotic pressure and fluid balance. Albumin plays a crucial role in maintaining osmotic pressure by helping to retain fluid within the blood vessels. This function is essential for regulating blood volume and preventing fluid from leaking out into tissues. Choices A, B, and D are incorrect because albumin is not primarily responsible for transporting oxygen, acting as a clotting factor, or functioning as an immune response molecule in the blood.

5. A patient is being treated with amphotericin B. Which of the following statements indicates that the patient has understood the patient teaching?

• A. “The medication may cause diabetes.”
• B. “The medication will cause liver necrosis.”
• C. “The medication may cause kidney damage.”
• D. “The medication will cause pancreatitis.”

Correct answer: C

Rationale: The correct answer is C: 'The medication may cause kidney damage.' Amphotericin B is known for its potential to cause nephrotoxicity, which can manifest as kidney damage. It is crucial for the patient to be aware of this possible adverse effect. Choices A, B, and D are incorrect because amphotericin B is not typically associated with causing diabetes, liver necrosis, or pancreatitis. Therefore, these statements do not reflect an accurate understanding of the medication's side effects.

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