Nursing Elites

1. A graduate nursing student requests information, including laboratory findings and chest x-ray results, about all clients with symptoms of H1N1 who have been seen during the last month in a community health clinic. Which action should the charge nurse take?

• A. Ask if permission has been obtained from the research committee.
• B. Ask the student to sign a standard waiver form.
• C. Obtain written authorization from clients to release the information.
• D. Provide the information for research purposes only.

Correct answer: C

Rationale: The correct action for the charge nurse to take is to obtain written authorization from clients to release the information. This step is crucial to ensure compliance with privacy laws and ethical standards. Asking for permission from the research committee (Choice A) may not address the individual clients' rights to privacy. Asking the student to sign a standard waiver form (Choice B) is not appropriate, as the authorization should come from the clients themselves. Providing the information for research purposes only (Choice D) without proper authorization violates client confidentiality and privacy.

2. A client with a history of coronary artery disease is admitted with chest pain. Which finding requires immediate intervention?

• A. Heart rate of 90 beats per minute.
• B. Blood pressure of 130/80 mm Hg.
• C. Respiratory rate of 20 breaths per minute.
• D. Chest pain radiating to the left arm.

Correct answer: D

Rationale: The correct answer is D. Chest pain radiating to the left arm can be a sign of myocardial infarction (heart attack) and requires immediate intervention. This symptom is known as a classic presentation of a heart attack and warrants urgent medical attention to prevent further cardiac damage. Choices A, B, and C are not directly indicative of an acute cardiac event and may not require immediate intervention in this scenario. While heart rate, blood pressure, and respiratory rate are important vital signs to monitor, they do not specifically indicate the urgency associated with chest pain radiating to the left arm in a patient with a history of coronary artery disease.

3. A school nurse is developing a health risk screening protocol for use at an elementary school. What information is most important for the nurse to include in this protocol?

• A. annual flu vaccination status
• B. weight and height measurement
• C. total cholesterol level
• D. long bone deformity testing

Correct answer: B

Rationale: Weight and height measurements are crucial components of health screenings in children as they help assess growth patterns and identify potential health concerns such as obesity or growth disorders. Monitoring weight and height regularly can aid in early intervention and prevention of health issues. Annual flu vaccination status, total cholesterol level, and long bone deformity testing are not typically primary components of routine health screenings in elementary school children and may not directly contribute to identifying common health risks in this population.

4. The nurse is preparing a teaching plan for a client who is newly diagnosed with hypothyroidism. Which instruction should the nurse include?

• A. Take levothyroxine (Synthroid) at bedtime.
• B. Increase fiber intake to prevent constipation.
• C. Take the medication on an empty stomach.
• D. Take a double dose if a dose is missed.

Correct answer: C

Rationale: The correct instruction for a client newly diagnosed with hypothyroidism is to take the medication on an empty stomach. This is important because taking levothyroxine on an empty stomach ensures better absorption of the medication. Choice A, taking levothyroxine at bedtime, is incorrect as it does not promote optimal absorption. Choice B, increasing fiber intake to prevent constipation, is important but not the priority when it comes to medication administration. Choice D, taking a double dose if a dose is missed, is dangerous and should never be advised as it can lead to overdose and serious side effects.

5. The healthcare provider is preparing to administer atropine, an anticholinergic, to a client scheduled for a cholecystectomy. The client asks the provider to explain the reason for the prescribed medication. What response is best for the provider to provide?

• A. To increase gastric motility.
• B. To decrease the risk of bradycardia during surgery.
• C. To reduce secretions.
• D. To prevent nausea and vomiting.

Correct answer: B

Rationale: Atropine, an anticholinergic medication, is used preoperatively to prevent bradycardia by increasing the automaticity of the sinoatrial node during surgical anesthesia. Choice A is incorrect because atropine does not affect gastric motility. Choice C is incorrect as atropine is not primarily used to reduce secretions. Choice D is also incorrect because preventing nausea and vomiting is not the primary purpose of administering atropine in this context.

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