Nursing Elites

1. A nurse is providing discharge teaching to the parent of a toddler who has a new diagnosis of asthma. The parent states she is unable to afford the nebulizer prescribed for the child. Which of the following referrals should the nurse recommend?

• A. Social worker
• B. Pharmacist
• C. Respiratory therapist
• D. Child protective services

Correct answer: A

Rationale: The correct answer is A: Social worker. A social worker can assist the parent in finding resources to afford the nebulizer. While a pharmacist may provide information about medications and devices, they may not have direct resources to address financial concerns. A respiratory therapist focuses on respiratory care but may not specialize in financial assistance. Referring to child protective services is not appropriate in this scenario as the parent's inability to afford a nebulizer does not indicate neglect or abuse.

2. What is the main objective of palliative care?

• A. To cure the disease
• B. To provide relief from symptoms and improve quality of life
• C. To extend hospital stays
• D. To focus solely on treatment

Correct answer: B

Rationale: The main objective of palliative care is to provide relief from symptoms and improve quality of life. Palliative care focuses on enhancing the quality of life for patients facing serious illnesses by providing relief from symptoms such as pain, stress, and other physical and emotional issues. Choice A is incorrect because palliative care does not aim to cure the disease but rather to manage symptoms. Choice C is incorrect as the goal of palliative care is not to extend hospital stays unnecessarily but to improve the patient's well-being. Choice D is incorrect as palliative care is not solely focused on treatment but takes a holistic approach to care that includes addressing physical, emotional, social, and spiritual needs.

3. Dr. Shrunk orders intravenous (IV) insulin for Rita, a client with a blood sugar of 563. Nurse AJ administers insulin lispro (Humalog) intravenously (IV). What does the best evaluation of the nurse reveal? Select one that does not apply.

• A. The nurse could have given the insulin subcutaneously.
• B. The nurse did not have to contact the physician.
• C. The nurse should have used regular insulin (Humulin R).
• D. The nurse used the correct insulin.

Correct answer: C

Rationale: The best evaluation of the nurse reveals that she should have used regular insulin (Humulin R) for IV administration. Regular insulin is the only insulin approved for intravenous administration due to its pharmacokinetic properties. Insulin lispro (Humalog) is not suitable for IV use. Choice A is incorrect because giving insulin intravenously is necessary in this case of high blood sugar. Choice B is incorrect because administering a different insulin without consulting the physician is not appropriate. Choice D is incorrect because the nurse used the incorrect insulin, which could pose risks to the client's health.

4. Which statement about adjuvant medications is true and accurate?

• A. Licensed practical nurses can administer adjuvant medications.
• B. Adjuvant medications are schedule 2 narcotics.
• C. Adjuvant medications are schedule 1 narcotics.
• D. Adjuvant medications can be purchased over the counter.

Correct answer: D

Rationale: The correct answer is D because adjuvant medications are often available over the counter without a prescription. Choices A, B, and C are incorrect. Choice A is incorrect because licensed practical nurses can administer adjuvant medications depending on their scope of practice. Choices B and C are incorrect because adjuvant medications are not classified as schedule 1 or schedule 2 narcotics.

5. A nurse is assessing a client who has meningitis. Which of the following findings should the nurse report to the provider immediately?

• A. Generalized rash over trunk
• B. Increased temperature
• C. Decreased level of consciousness
• D. Report of photophobia

Correct answer: C

Rationale: The correct answer is C: Decreased level of consciousness. In a client with meningitis, a decreased level of consciousness is a critical finding that should be reported immediately. This could indicate increased intracranial pressure or neurological deterioration, requiring prompt intervention. Choices A, B, and D are important in the assessment of meningitis but are not as immediately concerning as a decreased level of consciousness. A generalized rash over the trunk can be seen in meningococcal meningitis, an increased temperature is expected due to the inflammatory response, and photophobia is a common symptom due to meningeal irritation.

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