Nursing Elites

1. A patient has been diagnosed with fibromyalgia and COPD. Which of the following tasks should the nurse delegate to a nursing assistant?

• A. Transferring the patient to the shower.
• B. Ambulating the patient for the first time.
• C. Taking the patient's breath sounds.
• D. Educating the patient on monitoring fatigue.

Correct answer: A

Rationale: The correct answer is to delegate the task of transferring the patient to the shower to a nursing assistant. Nursing assistants are trained to assist with transfers safely, making this task appropriate for delegation. Ambulating the patient for the first time involves assessing the patient's mobility and tolerance, which requires more assessment and monitoring by a nurse, especially in a patient with fibromyalgia and COPD. Taking the patient's breath sounds involves assessing the patient's respiratory status, which is a nursing responsibility due to the need for clinical judgment. Educating the patient on monitoring fatigue involves providing vital information and should be done by the nurse to ensure comprehensive understanding and tailored recommendations.

2. A patient has recently been prescribed Norvasc. Which of the following side effects should the patient specifically watch out for?

• A. Hypotension and Angina
• B. Hypertension
• C. Lower extremity edema
• D. Peripheral sensory loss and SOB

Correct answer: A

Rationale: The correct answer is 'Hypotension and Angina.' Norvasc is a medication known to cause hypotension (low blood pressure) and angina (chest pain) as side effects. These side effects are important for the patient to watch out for as they can indicate potential issues related to the medication. Choice B ('Hypertension') is incorrect as Norvasc is actually used to treat hypertension, not cause it. Choice C ('Lower extremity edema') is not a common side effect of Norvasc. Choice D ('Peripheral sensory loss and SOB') is not typically associated with Norvasc's side effects.

3. Which of the following medications is a serotonin antagonist that might be used to relieve nausea and vomiting?

• A. metoclopramide (Reglan)
• B. ondansetron (Zofran)
• C. hydroxyzine (Vistaril)
• D. prochlorperazine (Compazine)

Correct answer: B

Rationale: Zofran is a serotonin antagonist that can be used to relieve nausea and vomiting. Ondansetron (Zofran) works by blocking serotonin receptors in the chemoreceptor trigger zone (CTZ) and the gastrointestinal tract. This action helps reduce nausea and vomiting. Metoclopramide (Reglan) works as a dopamine antagonist and also has prokinetic effects, making it effective for different conditions. Hydroxyzine (Vistaril) is an antihistamine with antiemetic properties, but it does not act as a serotonin antagonist. Prochlorperazine (Compazine) is a dopamine antagonist that is also used to treat nausea and vomiting, but not as a serotonin antagonist like ondansetron.

4. A healthcare professional is reviewing a patient's arterial blood gas values. Which of the following conditions apply under the following values? pH- 7.49 Bicarbonate ion 24 mEq/dl PaCO2 - 31 mmHg PaO2 - 52 mmHg FiO2 - 0.22

• A. respiratory acidosis
• B. respiratory alkalosis
• C. metabolic acidosis
• D. metabolic alkalosis

Correct answer: B

Rationale: The given blood gas values indicate respiratory alkalosis. A high pH and low PaCO2 level are consistent with respiratory alkalosis. In this scenario, no compensation for the alkalosis is noted, ruling out metabolic acidosis or alkalosis. Metabolic conditions would usually involve changes in bicarbonate levels, which remain within the normal range in this case.

5. In the treatment of symptomatic bradycardia, which medication is most commonly recognized?

• A. Questran
• B. Digitalis
• C. Nitroglycerin
• D. Atropine

Correct answer: D

Rationale: Atropine is the medication most commonly recognized for the treatment of symptomatic bradycardia because it increases the rate of conduction in the AV node, helping to alleviate bradycardia. Questran is a medication used to lower cholesterol levels and is not indicated for bradycardia. Digitalis, such as Digoxin, is used for heart failure and atrial fibrillation but not typically for bradycardia. Nitroglycerin is primarily used for angina and not bradycardia.

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