Nursing Elites

1. How should a healthcare professional care for a patient with a central venous catheter?

• A. Monitor for infection and change the dressing regularly
• B. Ensure the catheter is patent and flush as needed
• C. Educate the patient on self-care and proper hygiene
• D. Monitor blood glucose levels and administer IV fluids

Correct answer: A

Rationale: Corrected Rationale: Regular monitoring for infection and dressing changes are essential aspects of caring for a patient with a central venous catheter. Infections are a significant risk with these catheters, so vigilant monitoring and timely dressing changes help prevent complications. Choice B is important too, but ensuring catheter patency and flushing are more focused on maintaining the functionality of the catheter rather than infection prevention. Choice C is also important for patient education, but the immediate concern for a healthcare professional is monitoring and preventing infections related to the catheter. Choice D is not directly related to the care of a central venous catheter.

2. A client with newly diagnosed type I diabetes mellitus is being seen by the home health nurse. The physician orders include: 1,200-calorie ADA diet, 15 units of NPH insulin before breakfast, and check blood sugar qid. When the nurse visits the client at 5 PM, the nurse observes the man performing a blood sugar analysis. The result is 50 mg/dL. The nurse would expect the client to be

• A. Confused with cold, clammy skin and a pulse of 110
• B. Lethargic with hot, dry skin and rapid, deep respirations
• C. Alert and cooperative with a BP of 130/80 and respirations of 12
• D. Short of breath, with distended neck veins and a bounding pulse of 96

Correct answer: A

Rationale: The correct answer is A. Low blood sugar levels (50 mg/dL) typically cause confusion, cold clammy skin, and an increased pulse (tachycardia). Option A correctly describes the expected symptoms of hypoglycemia, which include confusion due to the brain's inadequate glucose supply, cold and clammy skin due to sympathetic nervous system activation, and an increased pulse (110 bpm) as the body reacts to low blood sugar levels. Options B, C, and D describe symptoms that are not typically associated with hypoglycemia. Lethargy, hot dry skin, rapid deep respirations, normal vital signs, shortness of breath, distended neck veins, and bounding pulse are more indicative of other conditions or normal physiological responses, not hypoglycemia.

3. When receiving change-of-shift report for a group of clients, which time-management strategy should the nurse plan to implement?

• A. Prepare a priority list of client needs for the shift
• B. Complete less time-consuming tasks first
• C. Handle urgent client needs at the end of the shift
• D. Work on each client as they are seen

Correct answer: A

Rationale: Preparing a priority list of client needs for the shift is the most effective time-management strategy for a nurse receiving change-of-shift report. This approach helps the nurse identify and address the most urgent client needs first, ensuring efficient use of time. Choice B is incorrect because focusing on less time-consuming tasks first may result in crucial tasks being delayed. Choice C is incorrect as urgent client needs should be handled promptly, not postponed until the end of the shift. Choice D is inefficient as it does not prioritize tasks based on urgency, potentially leading to delays in addressing critical client needs.

4. Which of the following is a key consideration when caring for a client with heart failure on fluid restriction?

• A. Encourage the client to drink more fluids to stay hydrated
• B. Weigh the client daily to monitor fluid status
• C. Limit the client's intake of fruits and vegetables
• D. Monitor the client's fluid intake only during meals

Correct answer: B

Rationale: When caring for a client with heart failure on fluid restriction, weighing the client daily is crucial to monitor fluid balance accurately. This helps healthcare providers assess if the client is retaining excess fluids, which can worsen heart failure. Encouraging the client to drink more fluids (choice A) contradicts the goal of fluid restriction. Limiting intake of fruits and vegetables (choice C) is not a specific guideline for managing fluid restriction in heart failure. Monitoring fluid intake only during meals (choice D) is insufficient as fluid balance needs to be monitored consistently throughout the day.

5. The nurse is making a home visit with a client diagnosed with Alzheimer's disease. The client recently started on lorazepam (Ativan) due to increased anxiety. The nurse is cautioning the family about the use of lorazepam (Ativan). The nurse should instruct the family to report which of the following significant side effects to the healthcare provider?

• A. Paradoxical excitement
• B. Headache
• C. Slowing of reflexes
• D. Fatigue

Correct answer: A

Rationale: The correct answer is A, paradoxical excitement. Lorazepam can cause an unexpected response of paradoxical excitement, which should be reported to the healthcare provider. This reaction is characterized by increased anxiety, restlessness, and agitation instead of the expected calming effect. Choices B, C, and D are incorrect because headache, slowing of reflexes, and fatigue are more common side effects of lorazepam and may not warrant immediate reporting unless severe or persistent.

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