Nursing Elites

1. A client with peptic ulcer disease is receiving ranitidine (Zantac). The nurse should monitor the client for which of the following side effects?

• A. Hypertension
• B. Constipation
• C. Diarrhea
• D. Hypotension

Correct answer: C

Rationale: The correct answer is C: Diarrhea. Ranitidine, which is used to treat peptic ulcer disease, can lead to gastrointestinal disturbances such as diarrhea. Choices A, B, and D are incorrect. Hypertension and hypotension are not common side effects of ranitidine. Constipation is also not a typical side effect associated with ranitidine use.

2. The family health care plan includes the following listed in sequence:

• A. objective, statement of the problem, intervention, and evaluation
• B. objectives, intervention, evaluation, and statement of the problem
• C. evaluation, statement of the problems, objectives, and interventions
• D. statement of the problems, objectives, intervention, and evaluation

Correct answer: D

Rationale: In a family health care plan, the correct sequence should start with identifying the problems (statement of the problems), setting objectives, planning interventions, and then evaluating the outcomes. This sequence ensures a logical and structured approach to healthcare planning. Choices A, B, and C are incorrect as they do not follow the logical order of healthcare planning steps.

3. Which of the following is not classified as an essential health service?

• A. Provision of eye glasses and dentures for the elderly
• B. Maternal and child care
• C. Basic sanitation and prevention and control of locally endemic diseases
• D. Promotion of proper nutrition, adequate supply of safe water, and health education

Correct answer: A

Rationale: The provision of eyeglasses and dentures for the elderly is not classified as an essential health service. Essential health services typically focus on preventive, promotive, curative, and rehabilitative care that address the primary healthcare needs of individuals and communities. Choices B, C, and D are examples of essential health services as they directly contribute to improving and maintaining the health of populations. Maternal and child care, basic sanitation, disease prevention, nutrition promotion, safe water supply, and health education are essential components of public health initiatives.

4. The nurse is performing a physical assessment on a client with insulin-dependent diabetes mellitus. Which client complaint calls for immediate nursing action?

• A. Diaphoresis and shakiness
• B. Reduced sensation in the lower leg
• C. Intense thirst and hunger
• D. Painful hematoma on thigh

Correct answer: A

Rationale: Diaphoresis and shakiness are classic signs of hypoglycemia in a client with insulin-dependent diabetes mellitus. Hypoglycemia is a medical emergency that requires immediate intervention to prevent further complications. The nurse should address this complaint promptly by providing a fast-acting source of glucose to raise the client's blood sugar levels. Reduced sensation in the lower leg may indicate peripheral neuropathy, which is a common complication of diabetes but does not require immediate action unless there are signs of injury. Intense thirst and hunger are symptoms of hyperglycemia, which also requires intervention but not as urgently as hypoglycemia. A painful hematoma on the thigh may require assessment and management, but it is not as urgent as addressing hypoglycemia.

5. The hospital is planning to downsize and eliminate a number of staff positions as a cost-saving measure. To assist staff in this change process, the nurse manager is preparing for the "unfreezing" phase of change. With this approach and phase the nurse manager should

• A. Discuss with the staff how to deal with any defensive behavior
• B. Explain to the unit staff why change is necessary
• C. Assist the staff during the acceptance of the new changes
• D. Clarify what the changes mean to the community and hospital

Correct answer: B

Rationale: The "unfreezing" phase involves preparing staff for change by explaining the necessity and benefits of the change, helping them to understand and accept it.

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