Nursing Elites

1. After a symptom is recognized, the first effort at treatment is often self-treatment. Which of the following statements is true about self-treatment?

• A. "Not recognized as valuable by most health care providers."?
• B. "Usually ineffective and may delay more effective treatment."?
• C. "Always less expensive than biomedical alternatives."?
• D. "Influenced by the accessibility of over-the-counter medicines."?

Correct answer: D

Rationale: After a symptom is identified, the first effort at treatment is often self-treatment. The availability of over-the-counter medications, the relatively high literacy level of Americans, and the influence of the internet and mass media in communicating health-related information to the general population have contributed to the high percentage of cases of self-treatment. Health care providers are recognizing the value of a wide variety of alternative, complementary, and traditional interventions. Many self-treatments, such as over-the-counter medications, are effective. Self-treatment is not always less expensive. Choice A is incorrect as health care providers are recognizing the value of self-treatment. Choice B is incorrect because self-treatment can be effective in many cases. Choice C is incorrect as self-treatment is not always less expensive; it depends on the specific treatment being used.

2. When is a physician likely to assess turgor?

• A. When iron deficiency is suspected.
• B. When heart and lung issues are suspected.
• C. When dehydration is suspected.
• D. None of the above.

Correct answer: C

Rationale: Skin turgor is assessed when dehydration is suspected. To evaluate skin turgor, a physician pinches the skin and observes how quickly it returns to its normal position. If the skin stays folded for an extended period, it indicates dehydration. Assessing turgor helps determine a patient's hydration status. Choice A is incorrect because skin turgor is not used to assess iron deficiency. Choice B is incorrect as turgor is not related to heart and lung issues, but rather hydration status. Choice D is incorrect as turgor assessment is relevant when dehydration is suspected.

3. While percussing over the liver of a patient, the nurse notices a dull sound. What should the nurse do?

• A. Consider this a normal finding
• B. Palpate this area for an underlying mass
• C. Reposition the hands and attempt to percuss in this area again
• D. Consider this finding as abnormal and refer the patient for additional treatment

Correct answer: A

Rationale: When percussing over relatively dense organs, such as the liver or spleen, a dull sound is a normal finding due to the organ's density. This occurs because the sound waves produced by tapping on the organ travel through the dense tissue, resulting in a dull sound. Therefore, the correct action for the nurse in this scenario is to consider a dull sound over the liver as a normal finding. Palpating for an underlying mass (Choice B) is not indicated based on the percussion finding alone. Repositioning the hands and repeating the percussion (Choice C) may not change the dull sound over the liver. Referring the patient for additional treatment (Choice D) without understanding the normal percussion findings over the liver would be premature. Thus, the most appropriate action is to interpret the dull sound as a normal finding.

4. What is the initial step to take when a patient passes out at the front desk?

• A. Call 911.
• B. Initiate CPR.
• C. Shake the patient and ask if they are okay.
• D. Check for a pulse.

Correct answer: C

Rationale: The correct initial step when a patient passes out at the front desk is to shake the patient gently and ask if they are okay. This step aims to assess the patient's level of responsiveness. Checking for a pulse or initiating CPR should only be done if the patient does not respond to being shaken. Calling 911 can be the next step after assessing the patient's immediate condition and providing necessary assistance.

5. Patients exhibiting signs of cyanosis will:

• A. show signs of hyperoxia.
• B. have increased O2 saturation.
• C. have blood levels of CO2 higher than O2 levels.
• D. None of the above.

Correct answer: C

Rationale: Cyanosis is a bluish discoloration of the skin and mucous membranes resulting from low blood oxygen levels. When a patient exhibits cyanosis, it indicates that their blood is poorly oxygenated, leading to a higher concentration of CO2 compared to oxygen. Options A and B are incorrect as cyanosis is associated with low oxygen levels, not hyperoxia or increased O2 saturation. Therefore, the correct answer is that patients exhibiting cyanosis will have blood levels of CO2 higher than O2 levels.

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