Nursing Elites

1. During surgery, the anesthesia personnel notice the client is having a steady rise in end-tidal carbon dioxide level. At this time, the nurse anesthetist begins to assess the client for malignant hyperthermia. The initial (priority) assessment for this disorder may include:

• A. measuring serum potassium levels.
• B. monitoring for muscle rigidity.
• C. evaluating renal function.
• D. checking arterial blood gases.

Correct answer: B

Rationale: The correct answer is B: monitoring for muscle rigidity. Muscle rigidity is a hallmark sign of malignant hyperthermia, a life-threatening condition triggered by certain anesthetics. Monitoring for this sign is critical in the early identification of the condition. Choices A, C, and D are not the initial priority assessments for malignant hyperthermia. Measuring serum potassium levels, evaluating renal function, and checking arterial blood gases are not specific initial assessments for malignant hyperthermia and would not aid in its early identification.

2. A patient has been prescribed clomiphene citrate (Clomid) for infertility. What should the nurse include in the teaching plan about the use of this medication?

• A. Clomiphene is taken daily for 5 days at the beginning of the menstrual cycle.
• B. Clomiphene is taken once daily throughout the menstrual cycle.
• C. Clomiphene is taken twice daily for 5 days at the end of the menstrual cycle.
• D. Clomiphene is taken three times daily for 10 days at the beginning of the menstrual cycle.

Correct answer: A

Rationale: Corrected Rationale: Clomiphene is typically taken daily for 5 days at the beginning of the menstrual cycle to stimulate ovulation. Choice A is the correct answer because it aligns with the standard dosing regimen for clomiphene citrate. Choices B, C, and D provide incorrect information about the dosing schedule for clomiphene, which can lead to ineffective treatment and potential side effects. Choice B suggests continuous daily intake, which is not the standard practice for clomiphene. Choice C and D mention different dosing frequencies and timings, which are not in line with the typical protocol for using clomiphene for infertility.

3. During an assessment of a male client suspected of having a disorder of motor function, which finding would suggest a possible upper motor neuron (UMN) lesion?

• A. Hypotonia
• B. Hyperreflexia
• C. Muscle atrophy
• D. Fasciculations

Correct answer: B

Rationale: Hyperreflexia, or exaggerated reflexes, is a common sign of an upper motor neuron (UMN) lesion. An UMN lesion indicates damage to the central nervous system pathways that control movement. Hypotonia (choice A) refers to reduced muscle tone, which is more indicative of lower motor neuron lesions. Muscle atrophy (choice C) suggests long-standing denervation or disuse of muscles. Fasciculations (choice D) are involuntary muscle contractions that can be seen in lower motor neuron lesions, like in amyotrophic lateral sclerosis (ALS), rather than UMN lesions.

4. A nurse is providing care for a 44-year-old male client who is admitted with a diagnosis of fever of unknown origin (FUO). Which characteristic of the client's history is most likely to have a bearing on his current diagnosis?

• A. The client is a smoker.
• B. The client has a history of IV drug use.
• C. The client was treated for an STD 2 years ago.
• D. The client has a family history of cardiac disease.

Correct answer: B

Rationale: A history of IV drug use is significant in cases of fever of unknown origin, as it increases the risk of infections like endocarditis, which can present with persistent fever. Smoking (Choice A) is not directly linked to FUO. While a history of STD treatment (Choice C) may be relevant, it is less likely to be associated with FUO compared to IV drug use. Family history of cardiac disease (Choice D) is not typically a primary factor in the diagnosis of FUO.

5. A patient is being educated about sildenafil (Viagra). Which of the following statements by the patient indicates that further teaching is necessary?

• A. I can take this medication with nitroglycerin.
• B. This medication can cause an erection lasting more than 4 hours.
• C. I should not take this medication if I am taking medications containing nitrates.
• D. This medication is safe to take with any over-the-counter medication.

Correct answer: A

Rationale: The correct answer is A because sildenafil should not be taken with medications containing nitrates, such as nitroglycerin, due to the risk of severe hypotension. Choice B is incorrect because priapism (prolonged erection) is a serious side effect but does not require immediate intervention like severe hypotension. Choice C is incorrect as it correctly identifies a contraindication for sildenafil use. Choice D is incorrect because not all over-the-counter medications are safe to take with sildenafil, and interactions can occur.

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