Nursing Elites

1. A healthcare professional is assessing a client for signs of anaphylaxis. Which of the following findings should the healthcare professional look for?

• A. Bradycardia
• B. Hypotension
• C. Increased appetite
• D. Decreased respiratory rate

Correct answer: B

Rationale: Hypotension is a critical sign of anaphylaxis. During anaphylaxis, there is a widespread vasodilation leading to a drop in blood pressure, which manifests as hypotension. This can be accompanied by other symptoms such as swelling, difficulty breathing, hives, and itching. Bradycardia (choice A) is not typically associated with anaphylaxis; instead, tachycardia is more common due to the body's response to the allergic reaction. Increased appetite (choice C) is unrelated to anaphylaxis, as individuals experiencing anaphylaxis often feel unwell and may have nausea or vomiting. Decreased respiratory rate (choice D) is also not a typical finding in anaphylaxis; instead, respiratory distress and wheezing are more commonly observed.

2. A nurse is caring for a client prescribed hydromorphone for severe pain. The client's respiratory rate has decreased from 16 breaths per minute to 6. Which of the following medications should the nurse prepare to administer?

• A. Naloxone
• B. Flumazenil
• C. Activated charcoal
• D. Aluminum hydroxide

Correct answer: A

Rationale: Naloxone is the correct answer. Naloxone is the antidote for opioid overdose, including hydromorphone. Opioids can cause respiratory depression, and a significant decrease in respiratory rate from 16 to 6 breaths per minute indicates respiratory compromise. Naloxone should be administered promptly to reverse the effects of the opioid and restore normal respiratory function. Flumazenil (Choice B) is used to reverse the effects of benzodiazepines, not opioids. Activated charcoal (Choice C) is used for gastrointestinal decontamination in cases of overdose with certain substances, but it is not the appropriate intervention for opioid-induced respiratory depression. Aluminum hydroxide (Choice D) is an antacid and has no role in managing opioid overdose or respiratory depression.

3. A nurse is planning to administer several medications to a client through an NG tube. Which actions should the nurse take?

• A. Dissolve crushed tablet medications in tap water
• B. Use 30-40 mL of sterile water for each medication
• C. Dissolve crushed tablet medications in sterile water
• D. Administer medications without dissolving

Correct answer: C

Rationale: The correct action for the nurse to take when administering medications through an NG tube is to dissolve crushed tablet medications in 15-30 mL of sterile water. This ensures proper delivery through the NG tube and reduces the risk of clogging. Choice A is incorrect because tap water may contain impurities that can cause complications. Choice B suggests using a higher volume of sterile water than necessary, which may lead to dilution of the medications. Choice D is incorrect as medications should be dissolved to prevent blockages in the NG tube.

4. A nurse is reviewing laboratory results for a client receiving chemotherapy. Which result should the nurse report to the provider?

• A. WBC 3,000/mm³
• B. Hemoglobin 12 g/dL
• C. Platelet count 250,000/mm³
• D. Serum sodium 140 mEq/L

Correct answer: A

Rationale: The correct answer is A: WBC 3,000/mm³. A WBC count of 3,000/mm³ indicates neutropenia, which is a condition characterized by a low level of white blood cells, specifically neutrophils. Neutropenia increases the risk of infection and requires immediate medical attention, especially in clients undergoing chemotherapy. Reporting this result to the provider promptly is crucial for further evaluation and intervention. Choices B, C, and D are within normal ranges and do not pose an immediate risk to the client's health. Hemoglobin of 12 g/dL, platelet count of 250,000/mm³, and serum sodium of 140 mEq/L are all normal values and would not typically require immediate reporting unless there are specific concerns related to the individual client's condition.

5. A charge nurse is preparing an educational session about addictive disorders for nursing staff. Which of the following should the nurse include as an etiological factor of addictive disorder?

• A. Low self-esteem
• B. Family history of addiction
• C. Personality disorders
• D. All of the above

Correct answer: D

Rationale: The correct answer is D: All of the above. Addiction is influenced by various factors, including low self-esteem, family history of addiction, and specific personality traits. Low self-esteem can lead individuals to seek solace in substances, a family history of addiction can increase the likelihood of developing addictive behaviors due to genetic and environmental factors, and certain personality disorders may contribute to addictive tendencies. Therefore, all the factors listed in choices A, B, and C can play a role in the development of addictive disorders. Choices A, B, and C are incorrect because addictive disorders are multifactorial, and it is essential to consider a combination of influences rather than isolating a single factor.

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