Nursing Elites

1. A patient has been prescribed Tegretol for the first time. Which of the following side effects is not associated with Tegretol?

• A. Sore throat
• B. Vertigo
• C. Fever
• D. Shortness of breath

Correct answer: D

Rationale: The correct answer is 'Shortness of breath.' Side effects commonly associated with Tegretol include sore throat, vertigo, and fever. Shortness of breath is not a typical side effect of Tegretol use. Sore throat, vertigo, and fever are known side effects of Tegretol, while shortness of breath is not typically linked to its use.

2. What do the following ABG values indicate: pH 7.38, PO2 78 mmHg, PCO2 36mmHg, and HCO3 24 mEq/L?

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

Correct answer: B

Rationale: The correct answer is 'homeostasis.' These ABG values fall within normal ranges, indicating a state of balance in the body's acid-base levels. Choices A, C, and D are incorrect as the ABG values provided do not point towards metabolic alkalosis, respiratory acidosis, or respiratory alkalosis. Instead, the values reflect a state of equilibrium where pH, PO2, PCO2, and HCO3 levels are within the normal range.

3. The client is being discharged after a concussion. Which of the following symptoms should be reported?

• A. Difficulty waking up
• B. Headache (3/10 on the pain scale)
• C. Bruising on knees and elbows
• D. Achy feeling all over

Correct answer: A

Rationale: The correct answer is 'Difficulty waking up' because it indicates a change in consciousness, which is a concerning symptom following a concussion. Reporting this symptom is crucial as it may signify a more severe head injury. 'Headache (3/10 on the pain scale)' may be common after a concussion but is not as urgent as a change in consciousness. 'Bruising on knees and elbows' is likely unrelated to the concussion and not a priority for reporting. 'Achy feeling all over' is a vague symptom and not specific to a concerning change in the client's condition post-concussion.

4. Which of the following individuals is at the highest risk for suicide?

• A. 76-year-old widow with chronic renal failure
• B. 19-year-old with new SSRI therapy
• C. 28-year-old post-partum crying weekly
• D. 50-year-old client with obsessive-compulsive disorder (OCD) and depression

Correct answer: A

Rationale: The correct answer is the 76-year-old widow with chronic renal failure. Elderly individuals with chronic diseases, especially men, are at very high risk for suicide. The other choices, although they may be vulnerable populations, do not carry as high a risk for suicide. The 19-year-old with new SSRI therapy may actually have a lower risk as they are receiving treatment. The 28-year-old post-partum individual is experiencing a common emotional response after childbirth, which is not necessarily indicative of a high suicide risk. The 50-year-old with OCD and depression is at risk but not as high as elderly individuals with chronic illness.

5. What is the most effective strategy to assist a client in recognizing and using personal strength?

• A. Encouraging the client's self-identification of strengths.
• B. Promoting the client's active external thinking.
• C. Listening to the client and providing advice as needed.
• D. Assisting the client in maintaining an external locus of control.

Correct answer: A

Rationale: Encouraging the client to identify their own strengths is empowering and helps build self-awareness and self-confidence. This strategy promotes autonomy and self-efficacy, enabling the client to recognize and utilize their personal strengths effectively. Option B, promoting the client's active external thinking, is vague and not directly related to recognizing personal strengths. Option C, listening to the client and providing advice as needed, focuses more on the nurse's role rather than empowering the client to recognize their strengths independently. Option D, assisting the client in maintaining an external locus of control, goes against the goal of helping the client recognize and utilize their internal strengths.

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