Nursing Elites

1. An 80-year-old client is given morphine sulfate for postoperative pain. Which concomitant medication should the nurse question that poses a potential development of urinary retention in this geriatric client?

• A. Nonsteroidal anti-inflammatory agents.
• B. Antihistamines.
• C. Tricyclic antidepressants.
• D. Antibiotics.

Correct answer: C

Rationale: The correct answer is C: Tricyclic antidepressants. Drugs with anticholinergic properties, such as tricyclic antidepressants, can exacerbate urinary retention associated with opioids in older clients. Nonsteroidal anti-inflammatory agents (Choice A) do not typically cause urinary retention. Antihistamines (Choice B) may cause urinary retention but are not the primary concern in this scenario. Antibiotics (Choice D) are not associated with an increased risk of urinary retention compared to tricyclic antidepressants.

2. Which annual screening should the nurse include when planning eye health programs at a preschool?

• A. visual acuity
• B. red light reflex
• C. conjunctivitis
• D. glaucoma

Correct answer: A

Rationale: The correct answer is A: visual acuity. Screening for visual acuity is essential in preschoolers to identify any vision issues early on, such as nearsightedness or farsightedness, which may require corrective lenses or other interventions. Red light reflex (choice B) is a method used to assess the eyes for abnormalities, but it is not typically included in routine preschool eye health screenings. Conjunctivitis (choice C) is an eye infection and not a screening test. Glaucoma (choice D) is a condition more commonly associated with adults and the elderly, making it less relevant for preschool eye health programs.

3. The nurse is planning an immunization campaign targeting the children of migrant farm workers in the community. Which data should the nurse review before exploring solution options when developing this program plan?

• A. uncertain risks
• B. potential outcomes
• C. priority of solutions
• D. target population data

Correct answer: D

Rationale: Correct. Before designing an immunization campaign for the children of migrant farm workers, the nurse should review target population data. This includes understanding the specific demographics, health needs, and challenges faced by this population to create a tailored and effective program. Reviewing uncertain risks (choice A) may not provide actionable insights for program development. Considering potential outcomes (choice B) is important but comes after understanding the target population. Evaluating the priority of solutions (choice C) is premature without knowing the specific characteristics and needs of the target population.

4. A homeless client with alcohol dependency will be dismissed from the emergency department in 24 hours. The nurse notes that a tuberculin skin test was prescribed by the healthcare provider. What intervention is most important for the nurse to implement prior to discharge?

• A. Identify how the client will follow-up to have the results read
• B. Give the client written information about the tuberculosis test
• C. Determine if the client understands the purpose of the tuberculin test
• D. Explain to the client results should be read between 48 and 72 hours

Correct answer: A

Rationale: The most important intervention for the nurse to implement prior to the discharge of a homeless client with alcohol dependency who had a tuberculin skin test prescribed is to identify how the client will follow-up to have the results read. This is crucial to ensure proper diagnosis and treatment. Providing written information (Choice B) is helpful but not as critical as ensuring the follow-up plan. Determining if the client understands the purpose of the test (Choice C) is important but not as immediate as ensuring the follow-up plan. Explaining when the results should be read (Choice D) is important, but the priority is to make sure the client has a plan in place for follow-up.

5. The nurse is caring for a client with Addison's disease. Which finding requires immediate intervention?

• A. Hyperpigmentation of the skin.
• B. Low blood pressure.
• C. Nausea and vomiting.
• D. Hypoglycemia.

Correct answer: B

Rationale: Low blood pressure in a client with Addison's disease requires immediate intervention as it can indicate an Addisonian crisis, a life-threatening condition that necessitates prompt treatment. Hyperpigmentation of the skin is a characteristic finding in Addison's disease but does not require immediate intervention. Nausea and vomiting can be managed symptomatically in Addison's disease. While hypoglycemia needs attention, it is not the most critical finding requiring immediate intervention in this context.

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