Nursing Elites

1. A client with asthma receives a prescription for high blood pressure during a clinic visit. Which prescription should the nurse anticipate the client to receive that is least likely to exacerbate asthma?

• A. Pindolol (Visken)
• B. Carteolol (Ocupress)
• C. Metoprolol tartrate (Lopressor)
• D. Propranolol hydrochloride (Inderal)

Correct answer: C

Rationale: The correct answer is C, Metoprolol tartrate (Lopressor). Metoprolol is a beta2 blocking agent that is cardioselective and less likely to cause bronchoconstriction, making it a suitable antihypertensive option for clients with asthma. Choices A, B, and D are non-selective beta-blockers which can potentially exacerbate asthma symptoms by causing bronchoconstriction.

2. The school nurse is developing an individualized healthcare plan for a student with type 1 diabetes. Which component is most important to include in the plan?

• A. a schedule for blood glucose monitoring
• B. a list of low-carbohydrate snacks
• C. a contact list of healthcare providers
• D. a log for recording insulin administration

Correct answer: A

Rationale: The correct answer is A: a schedule for blood glucose monitoring. Regular blood glucose monitoring is essential in managing type 1 diabetes as it helps in monitoring blood sugar levels, adjusting treatment plans, and preventing complications such as hypoglycemia or hyperglycemia. Choice B, a list of low-carbohydrate snacks, while important for managing blood sugar levels, is not as critical as consistent blood glucose monitoring. Choice C, a contact list of healthcare providers, though important for emergency situations, is not the most crucial component in managing daily care. Choice D, a log for recording insulin administration, is valuable for tracking insulin doses but does not directly address the immediate need for monitoring blood glucose levels.

3. A client who is receiving total parenteral nutrition (TPN) has an elevated blood glucose level. Which action should the nurse take first?

• A. Stop the TPN infusion.
• B. Administer insulin as prescribed.
• C. Notify the healthcare provider.
• D. Check the TPN infusion rate.

Correct answer: D

Rationale: The correct first action for a client receiving TPN with an elevated blood glucose level is to check the TPN infusion rate. Elevated blood glucose levels in clients receiving TPN can be due to incorrect infusion rates leading to increased glucose delivery. By checking the TPN infusion rate, the nurse can verify if the rate is appropriate and make necessary adjustments. Stopping the TPN infusion abruptly could lead to complications from sudden nutrient deprivation. Administering insulin as prescribed may be necessary but should come after ensuring the correct TPN infusion rate. Notifying the healthcare provider is important but addressing the immediate need to check the infusion rate takes priority to manage hyperglycemia effectively.

4. Which client has the highest risk for developing community-acquired pneumonia?

• A. a 40-year-old first-grade teacher who works with underprivileged children
• B. a 75-year-old retired secretary with exercise-induced wheezing
• C. a 60-year-old homeless person who is an alcoholic and smokes
• D. a 35-year-old aerobics instructor who skips meals and eats only vegetables

Correct answer: C

Rationale: The correct answer is C, a 60-year-old homeless person who is an alcoholic and smokes. This client has the highest risk of developing community-acquired pneumonia due to multiple factors such as homelessness, substance abuse, and smoking. Homelessness can lead to poor living conditions and limited access to healthcare, increasing susceptibility to infections. Alcoholism and smoking weaken the immune system, making individuals more vulnerable to respiratory infections like pneumonia. Choices A, B, and D do not present the same level of risk factors for pneumonia compared to choice C.

5. A public health nurse is evaluating a program designed to reduce the incidence of sexually transmitted infections (STIs) among teenagers. Which outcome indicates that the program is successful?

• A. increased attendance at educational sessions on STIs
• B. higher rates of condom use among teenagers
• C. more teenagers seeking testing for STIs
• D. greater knowledge of STI prevention methods

Correct answer: B

Rationale: The correct answer is B: higher rates of condom use among teenagers. This outcome indicates that the teenagers are adopting safer sexual practices, which can effectively reduce the incidence of STIs. Increased attendance at educational sessions (Choice A) may show interest but does not directly reflect behavior change. More teenagers seeking testing for STIs (Choice C) indicates awareness but not necessarily prevention. Greater knowledge of STI prevention methods (Choice D) is valuable but does not guarantee behavioral change like increased condom use.

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