Nursing Elites

1. A diabetic patient who has reported burning foot pain at night receives a new prescription. Which information should the nurse teach the patient about amitriptyline (Elavil)?

• A. Amitriptyline decreases the depression caused by your foot pain.
• B. Amitriptyline helps prevent transmission of pain impulses to the brain.
• C. Amitriptyline corrects some of the blood vessel changes that cause pain.
• D. Amitriptyline improves sleep and reduces awareness of nighttime pain.

Correct answer: B

Rationale: The correct answer is B. Amitriptyline is a tricyclic antidepressant that works by inhibiting the reuptake of serotonin and norepinephrine, which helps in reducing the transmission of pain impulses to the brain. Choice A is incorrect because amitriptyline primarily works on pain transmission rather than directly on depression. Choice C is inaccurate as amitriptyline's mechanism of action is not related to correcting blood vessel changes. Choice D is partially true as amitriptyline can improve sleep, but the primary mechanism related to pain relief is by preventing pain impulses from reaching the brain.

2. A new nurse is thinking about the ways she can demonstrate leadership in her position. Which of the following is true about leadership?

• A. Leadership is a component of nursing practice.
• B. Leadership requires a position of oversight.
• C. Leadership depends on the actions of others.
• D. Only experienced nurses can demonstrate leadership.

Correct answer: A

Rationale: The correct answer is A: 'Leadership is a component of nursing practice.' Leadership is an essential aspect of nursing practice that involves inspiring, guiding, and influencing others to achieve common goals. Choice B is incorrect because leadership can be demonstrated at various levels within an organization, not just positions of oversight. Choice C is incorrect as leadership involves taking initiative and guiding others, rather than depending solely on the actions of others. Choice D is incorrect as leadership qualities can be demonstrated by individuals at all levels of experience, not exclusively by experienced nurses.

3. The healthcare provider suspects the Somogyi effect in a 50-year-old patient whose 6:00 AM blood glucose is 230 mg/dL. Which action will the nurse teach the patient to take?

• A. Avoid snacking at bedtime.
• B. Increase the rapid-acting insulin dose.
• C. Check the blood glucose during the night.
• D. Administer a larger dose of long-acting insulin.

Correct answer: C

Rationale: The Somogyi effect, also known as rebound hyperglycemia, occurs due to an excessive insulin dose at night, leading to hypoglycemia in the early morning hours. To address this, the nurse should instruct the patient to check their blood glucose during the night to determine if hypoglycemia is present, which triggers the rebound hyperglycemia. By monitoring blood glucose levels during the night, the patient can identify if adjustments are needed to prevent this phenomenon and maintain stable glucose levels. Choices A, B, and D are incorrect. Avoiding snacking at bedtime, increasing rapid-acting insulin dose, or administering a larger dose of long-acting insulin are not appropriate actions to manage the Somogyi effect. Checking blood glucose during the night is crucial to identify and prevent the rebound hyperglycemia characteristic of this phenomenon.

4. A postoperative nurse is caring for a client after knee replacement. She discovers the consent was not signed before the surgery. Which of the following charges could be filed?

• A. False imprisonment
• B. Libel
• C. Battery
• D. Malpractice

Correct answer: C

Rationale: The correct answer is C: 'Battery.' Battery could be charged if the consent was not signed before surgery. In this scenario, the lack of signed consent could constitute a case of battery, as the procedure was performed without the patient's explicit permission. Choice A, 'False imprisonment,' does not apply in this context, as it refers to the unlawful confinement of a person. Choice B, 'Libel,' involves making false statements that harm someone's reputation in writing, which is not relevant to the situation described. Choice D, 'Malpractice,' typically refers to professional negligence or failure to meet a standard of care, which is not the primary concern in this case.

5. What is the primary advantage of utilizing a modular nursing model?

• A. Improved patient satisfaction
• B. Enhanced teamwork
• C. Cost reduction
• D. Improved communication

Correct answer: B

Rationale: The primary advantage of utilizing a modular nursing model is enhanced teamwork and collaboration among nurses. While improved patient satisfaction, cost reduction, and improved communication are essential in healthcare settings, the modular nursing model specifically focuses on restructuring care delivery to promote teamwork and efficiency. Therefore, choices A, C, and D are not the primary advantages of using a modular nursing model.

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