Nursing Elites

1. Lidocaine is a medication frequently ordered for the client experiencing

• A. Atrial tachycardia
• B. Ventricular tachycardia
• C. Heart block
• D. Ventricular bradycardia

Correct answer: B

Rationale: Lidocaine is used to treat ventricular tachycardia. This medication slowly exerts an antiarrhythmic effect by increasing the electrical stimulation threshold of the ventricles without depressing the force of ventricular contractions. It is not used for atrial arrhythmias; thus, answer A is incorrect. Answers C and D are incorrect because lidocaine does not slow the heart rate, so it is not used for heart block or bradycardia.

2. Which of the following solutions is routinely used to flush an IV device before and after the administration of blood to a client?

• A. 0.9% sodium chloride
• B. 5% dextrose in water solution
• C. Sterile water
• D. Heparin sodium

Correct answer: A

Rationale: The correct answer is 0.9% sodium chloride. Normal saline is 0.9% sodium chloride, which has the same osmolarity as blood and does not cause cell lysis. Choices 2 and 3, 5% dextrose in water solution and sterile water, are hypotonic solutions that can lead to cell lysis. Choice 4, Heparin sodium, is an anticoagulant and is not routinely used to flush an IV device before and after the administration of blood.

3. Which of the following post-operative diets is most appropriate for the client who has had a hemorrhoidectomy?

• A. High-fiber
• B. Low-residue
• C. Bland
• D. Clear-liquid

Correct answer: D

Rationale: The correct answer is 'Clear-liquid.' After a hemorrhoidectomy, the client is usually started on a clear-liquid diet to allow the intestines to rest and promote healing. This diet helps prevent straining during bowel movements, which is crucial for recovery. Stool softeners are often included in the plan to avoid constipation. Once the client tolerates the clear liquids well, they can progress to a regular diet. High-fiber diet (choice A) is beneficial in the later stages of recovery to prevent constipation but is not typically the initial post-operative diet. Low-residue diet (choice B) and bland diet (choice C) are not appropriate for this type of surgery as they may not provide the necessary post-operative care and support needed for healing.

4. A man expresses surprise that his wife has become very withdrawn during hospitalization for pneumonia. Which response helps the husband understand how some people cope with hospitalization?

• A. "Hospitalization might cause a crisis. Has your wife had to cope with problems before this?"?
• B. "Some people react that way. She will be more talkative when she feels better."?
• C. "Your wife might be feeling concern that she cannot fulfill her normal roles."?
• D. "This is typical behavior for someone who is as ill as your wife."?

Correct answer: A

Rationale: The correct response acknowledges that hospitalization can lead to a crisis for both patients and their families. By asking if the wife has coped with problems before, it opens up a dialogue about her coping mechanisms and past experiences. This can help the husband understand his wife's current behavior better and provide valuable insights. Choices B, C, and D do not directly address the potential crisis that hospitalization can cause or inquire about the wife's coping strategies, making them less effective responses.

5. What are the three major sequential maturational crises for females?

• A. puberty, pregnancy, and menopause.
• B. death of a spouse, menopause, and childbirth.
• C. rape, divorce, and menarche.
• D. dating, engagement, and separation.

Correct answer: A

Rationale: The three major sequential maturational crises affecting females are puberty, pregnancy, and menopause. Puberty signifies the beginning of menarche, the first menstrual period. Pregnancy is a transformative experience with long-lasting effects on a woman's life. Menopause marks the end of menstrual cycles. These milestones are well-documented in research and are significant events in a woman's life. Nurses play a vital role in supporting females through these stages. Choices B, C, and D are incorrect as they do not accurately represent the recognized sequential maturational crises in a female's life.

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