Nursing Elites

1. A client who is newly diagnosed with Parkinson's disease and beginning medication therapy asks the nurse, 'How soon will I see improvement?' The nurse's best response is:

• A. "That varies from client to client."?
• B. "You should discuss that with your physician."?
• C. "You should notice a difference in a few days."?
• D. "It might take several weeks before you notice improvement."?

Correct answer: D

Rationale: In the case of Parkinson's disease, improvement in symptoms may take several weeks of therapy to become noticeable. Therefore, the correct answer is to inform the client that it might take several weeks before they notice improvement. Choice A acknowledges individual variability but does not provide a specific timeframe, making it less reassuring. Choice B suggests deferring the question to the physician, which is not the most supportive response. Choice C is incorrect because improvement in Parkinson's disease symptoms typically does not occur within a few days.

2. A nurse has been ordered to set up Buck's traction on a patient's lower extremity due to a femur fracture. Which of the following applies to Buck's traction?

• A. A weight greater than 10 lbs. should be used.
• B. The line of pull is upward at an angle.
• C. The line of pull is straight
• D. A weight greater than 20 lbs. should be used.

Correct answer: C

Rationale: The correct answer is that the line of pull is straight for Buck's traction. This type of traction is applied to maintain alignment and immobilization of fractures, typically involving the lower extremities. A straight line of pull helps to provide the necessary countertraction to keep the fractured bone in proper alignment. Choices A and D are incorrect because Buck's traction commonly uses a weight range between 5-10 lbs, and using a weight greater than 10 or 20 lbs would not be appropriate or safe. Choice B is incorrect as well since the line of pull for Buck's traction is straight, not upward at an angle.

3. What are the side effects of first-generation over-the-counter (OTC) antihistamines like diphenhydramine (Benadryl) and hydroxyzine (Atarax) in infants and children?

• A. Reye's syndrome.
• B. cholinergic effects.
• C. paradoxical CNS stimulation.
• D. nausea and diarrhea.

Correct answer: C

Rationale: The correct answer is paradoxical CNS stimulation. First-generation OTC antihistamines, such as diphenhydramine and hydroxyzine, can lead to paradoxical CNS stimulation in infants and children. This phenomenon is characterized by symptoms like excitement, euphoria, restlessness, and confusion, rather than the expected sedative effect. Due to this unexpected response, these antihistamines are used less frequently in pediatric populations. Reye's syndrome is a rare systemic response to a virus and is not a side effect of antihistamines. First-generation OTC antihistamines do not typically exhibit cholinergic effects. Nausea and diarrhea are uncommon side effects of these antihistamines and are less commonly observed than paradoxical CNS stimulation.

4. In alcoholics with anemia:

• A. Pernicious anemia is more common than folic acid deficiency.
• B. Iron deficiency and folic acid deficiency can coexist.
• C. The alcohol interferes with iron absorption.
• D. Oral vitamin replacement is contraindicated.

Correct answer: B

Rationale: In alcoholics with anemia, iron deficiency and folic acid deficiency can coexist due to poor dietary intake and malabsorption issues associated with chronic alcohol consumption. Pernicious anemia, primarily related to vitamin B12 deficiency, is not commonly seen in alcoholics. While alcohol can interfere with iron absorption, it is not the sole factor contributing to anemia in alcoholics. Oral vitamin replacement is not contraindicated in alcoholics with anemia; however, it may be less effective due to absorption issues related to alcohol consumption.

5. Which statement best describes electrolytes in intracellular and extracellular fluid?

• A. There is a greater concentration of sodium in extracellular fluid and potassium in intracellular fluid
• B. There is an equal concentration of sodium and potassium in extracellular fluid
• C. There is a greater concentration of potassium in extracellular fluid and sodium in intracellular fluid
• D. There is an equal concentration of sodium and potassium between intracellular and extracellular fluid

Correct answer: A

Rationale: Electrolytes are distributed unequally between intracellular and extracellular fluids. Sodium concentration is higher in extracellular fluid, while potassium concentration is higher in intracellular fluid. Therefore, the correct answer is 'There is a greater concentration of sodium in extracellular fluid and potassium in intracellular fluid.' Choices B, C, and D are incorrect because they do not accurately describe the typical distribution of sodium and potassium between intracellular and extracellular fluid.

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