Nursing Elites

1. An elderly client is diagnosed with ovarian cancer. She has surgery followed by chemotherapy with fluorouracil (Adrucil) IV. What should the nurse do if she notices crystals and cloudiness in the IV medication?

• A. Discard the solution and order a new bag
• B. Warm the solution
• C. Continue the infusion and document the finding
• D. Discontinue the medication

Correct answer: A

Rationale: Crystals in the solution are not normal and should not be administered to the client. Discarding the solution and ordering a new bag is the correct action to ensure the client's safety. Warming the solution, as suggested in answer B, will not resolve the issue of crystals and cloudiness, which could potentially harm the client. Continuing the infusion, as in answer C, could pose a risk to the client due to the presence of abnormal substances. Answer D, discontinuing the medication, would typically require a doctor's order and should be done after discarding the contaminated solution.

2. A client visits the clinic after the death of a parent. Which statement made by the client's sister signifies abnormal grieving?

• A. "My sister still has episodes of crying, and it's been 3 months since Daddy died."?
• B. "Sally seems to have forgotten the bad things that Daddy did in his lifetime."?
• C. "She really had a hard time after Daddy's funeral. She said that she had a sense of longing."?
• D. "Sally has not been sad at all about Daddy's death. She acts like nothing has happened."?

Correct answer: D

Rationale: Abnormal grieving is often characterized by a lack of sadness or acknowledgment of the loss. In this scenario, the statement 'Sally has not been sad at all about Daddy's death. She acts like nothing has happened' indicates abnormal grieving as it suggests a lack of emotional response or denial of the death. On the other hand, choices A, B, and C all describe normal grieving reactions: crying episodes, selective memory of the deceased, and feelings of longing after the funeral. These responses are typical in the grieving process. Therefore, choice D is the correct answer, highlighting a potential abnormality in the grieving process.

3. Which of the following statements by a client with spinal cord injury indicates a need for further teaching by the nurse regarding bowel management?

• A. "I should avoid eating foods that produce gas."?
• B. "I should drink more fluids like water and non-caffeinated fruit juices."?
• C. "I should set a regular schedule for bowel movements."?
• D. "I should sit in an upright position for bowel movements."?

Correct answer: B

Rationale: The corrected statement indicates the need for further teaching because it suggests consuming fluids like fruit juices, which can include caffeinated options that may stimulate fluid loss through increased urination. It is more appropriate to emphasize the consumption of fluids like water and non-caffeinated fruit juices for proper hydration. Choices A, C, and D demonstrate a correct understanding of bowel management by focusing on dietary considerations, establishing a regular bowel movement schedule, and using proper positioning during bowel movements. Option B is incorrect as it may lead to increased fluid loss due to caffeine content in some fruit juices.

4. The licensed practical nurse assigned to the postpartum unit is preparing to administer Rhogam to a postpartum client. Which woman is not a candidate for RhoGam?

• A. A gravida IV para 3 that is Rh negative with an Rh-positive baby
• B. A gravida I para 1 that is Rh negative with an Rh-positive baby
• C. A gravida II para 0 that is Rh negative admitted after a stillbirth delivery
• D. A gravida IV para 2 that is Rh negative with an Rh-negative baby

Correct answer: D

Rationale: The mothers in answers A, B, and C all require RhoGam as they are Rh negative with an Rh-positive baby or have experienced a stillbirth delivery, making them candidates for RhoGam injection. The mother in answer D is the only one who does not require Rhogam because she is Rh negative with an Rh-negative baby, eliminating the need for RhoGam administration.

5. Incidences of child abuse appear to be higher in the African-American community and might be explained by:

• A. the increased number of single-parent households in African-American communities
• B. more single-parent households in African-American communities
• C. stricter child-rearing practices in African-American households
• D. a higher occurrence of rage in African Americans

Correct answer: B

Rationale: Child abuse is often associated with lower socioeconomic status and single-parent households due to increased stress and fewer support systems. Choice A is correct as single-parent households can face more challenges leading to a higher risk of child abuse. Choice B is the correct answer as it aligns with the risk factors associated with child abuse. Choice C is incorrect because there is no direct correlation between stricter child-rearing practices and child abuse rates. Choice D is incorrect because attributing child abuse to a higher occurrence of rage in African Americans is a stereotype and lacks evidence.

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