Nursing Elites

1. Following a classic cholecystectomy resection for multiple stones, the PACU nurse observes serosanguinous drainage on the dressing. The most appropriate intervention is to:

• A. notify the physician of the drainage
• B. change the dressing
• C. reinforce the dressing
• D. apply an abdominal binder

Correct answer: C

Rationale: In the context of a classic cholecystectomy resection, serosanguinous drainage is an expected finding postoperatively due to the nature of the surgery. The appropriate intervention in this situation is to reinforce the dressing. Changing the dressing prematurely can increase the risk of introducing infection. Applying an abdominal binder is not recommended as it can obstruct the visualization of the dressing and the underlying wound, making it difficult to monitor for any complications or changes in drainage. Notifying the physician may be necessary if there are significant changes in the drainage characteristics or other concerning signs, but the immediate action should be to reinforce the dressing to maintain a clean and secure environment for wound healing.

2. Why is Kleinman's Explanatory Model of Health and Illness significant?

• A. it explains the health beliefs a family is likely to have.
• B. it emphasizes the role of culture in shaping health explanations.
• C. it discusses the significant role of popular and folk domains of influence.
• D. it is structured based on education.

Correct answer: B

Rationale: Kleinman's Explanatory Model of Health and Illness is significant because it emphasizes the crucial role that popular and folk domains of influence play in shaping individuals' understanding of health and illness. Kleinman distinguishes between disease, which is the biomedical understanding of health problems, and illness, which is the individual's personal interpretation of their health condition. By focusing on the cultural factors that influence these domains of influence, Kleinman's model underscores the impact of cultural beliefs and practices on health perceptions. Choice A is incorrect because the model goes beyond just family health beliefs. Choice B is more precise as it emphasizes the broader influence of culture. Choice C highlights the correct significance of popular and folk domains of influence, making it the correct choice. Choice D is incorrect as the model's significance lies in cultural domains, not educational structure.

3. An adult client tells the clinic nurse that he is susceptible to middle ear infections. About which risk factor related to infection of the ears does the nurse question this client?

• A. Loud music
• B. Use of power tools
• C. Occupational noise
• D. Exposure to cigarette smoke

Correct answer: D

Rationale: The correct answer is 'Exposure to cigarette smoke.' Otitis media (middle ear infection) is associated with various factors like colds, allergies, sore throats, and blockage of the eustachian tubes. Risk factors include exposure to cigarette smoke, youth (as otitis media is usually a childhood disease), congenital abnormalities, immune deficiencies, family history of otitis media, recent upper respiratory infections, and allergies. Choices A, B, and C (Loud music, Use of power tools, and Occupational noise) are more likely to cause hearing loss rather than being direct risk factors for middle ear infections.

4. When a client describes their family as having multiple wives, all of whom are sisters, married to one man, the nurse documents the family structure as?

• A. polyandry
• B. sororal
• C. nonsororal
• D. soronal

Correct answer: D

Rationale: The correct answer is 'soronal.' The practice of polygamy refers to having multiple wives or husbands. When there are multiple wives who are sisters, the polygamy is designated as sororal. Polyandry refers to multiple husbands, which is rare. Nonsororal polygamy is when the wives are not sisters. Sororate polygamy specifies that a husband must marry his wife’s sister if she dies. Therefore, in this scenario, the family structure described by the client fits the definition of soronal polygamy.

5. A teenage client is admitted to the hospital because of acetaminophen (Tylenol) overdose. Overdoses of acetaminophen can precipitate life-threatening abnormalities in which of the following organs?

• A. lungs
• B. liver
• C. kidneys
• D. adrenal glands

Correct answer: B

Rationale: Acetaminophen is extensively metabolized in the liver. An overdose of acetaminophen can lead to severe liver damage and even liver failure, which can be life-threatening. Choices A, C, and D are incorrect because although prolonged use of acetaminophen may lead to an increased risk of renal dysfunction, a single overdose does not typically cause life-threatening abnormalities in the lungs, kidneys, or adrenal glands.

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