Nursing Elites

1. In some hip surgeries, an epidural catheter for Fentanyl epidural analgesia is given. What is your nursing priority care in such a case?

• A. Instruct the client to observe strict bed rest
• B. Check for epidural catheter drainage
• C. Administer analgesia through the epidural catheter as prescribed
• D. Assess respiratory rate carefully

Correct answer: D

Rationale: The nursing priority care in a case where an epidural catheter for Fentanyl epidural analgesia is given during hip surgeries is to assess the respiratory rate carefully. Respiratory depression is a potential side effect of Fentanyl, especially when administered epidurally. Monitoring the respiratory rate is crucial to detect any signs of respiratory distress promptly. Instructing the client to observe strict bed rest (Choice A) may be necessary but is not the priority over ensuring respiratory function. Checking for epidural catheter drainage (Choice B) and administering analgesia through the epidural catheter as prescribed (Choice C) are important aspects of care, but ensuring adequate ventilation takes precedence to prevent complications.

2. Diseases of the heart and blood vessels are collectively referred to as _____.

• A. Coronary artery disease
• B. Cardiovascular disease
• C. Coronary heart disease
• D. Coronary vessel disease

Correct answer: B

Rationale: The correct term for diseases of the heart and blood vessels is cardiovascular disease. While coronary artery disease (Choice A) specifically involves the narrowing of coronary arteries, it is just one type of cardiovascular disease. Coronary heart disease (Choice C) is also a specific condition related to the heart's blood vessels. Choice D, coronary vessel disease, is not a commonly used term to describe diseases of the heart and blood vessels. Therefore, Choice B, cardiovascular disease, is the most inclusive and appropriate term to refer to these conditions.

3. Which organ absorbs water and vitamin K and may be affected by ulcerative colitis?

• A. Stomach
• B. Pancreas
• C. Large intestine
• D. Small intestine

Correct answer: C

Rationale: The large intestine is the organ that is primarily responsible for the absorption of water and vitamin K in the human body. A disease like ulcerative colitis can disrupt these functions by causing inflammation and ulcers in the lining of the large intestine, leading to digestive issues. The stomach (Choice A) primarily functions to break down and digest food, not to absorb water and vitamins. The pancreas (Choice B) secretes enzymes to aid in digestion and hormones to regulate blood sugar, but does not absorb water and vitamins. The small intestine (Choice D) is primarily responsible for absorbing nutrients from digested food, but not specifically water and vitamin K. Therefore, these other choices are incorrect.

4. What is the most important concern immediately after a myocardial infarction?

• A. Reducing cholesterol intake
• B. Allowing cardiac rest for healing
• C. Reducing saturated fat intake
• D. Eating several small meals each day

Correct answer: B

Rationale: Immediately after a myocardial infarction, the primary concern is to allow the heart to rest and heal to prevent further damage. This is why choice B is the correct answer. While choices A, C, and D might be a part of the long-term management plan following a myocardial infarction, they are not the immediate priority. Reducing cholesterol and saturated fat intake, as well as adjusting eating habits can help prevent future heart issues, but do not directly contribute to the immediate recovery post-myocardial infarction.

5. Which nursing diagnosis has nutritional implications?

• A. impaired dentition
• B. disruption of gas exchange
• C. self-esteem disturbance
• D. sleep pattern disturbance

Correct answer: A

Rationale: Impaired dentition affects a patient's ability to chew and consume a variety of foods, leading to potential nutritional deficiencies and malnutrition.

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