Nursing Elites

1. Mr. Y had surgery two days ago and is recovering on the surgical unit of the hospital. Just before lunch, he develops chest pain and difficulties with breathing. His respiratory rate is 32/minute, his temperature is 100.8�F, and he has rales on auscultation. Which of the following nursing interventions is most appropriate in this situation?

• A. Place the client in the Trendelenburg position
• B. Contact the physician for an order for antibiotics
• C. Administer oxygen therapy
• D. Decrease his IV rate

Correct answer: C

Rationale: Chest pain, dyspnea, tachypnea, mild fever, and rales or crackles on auscultation in a client who had surgery 2 days ago may be indicative of a pulmonary embolism. The nurse should administer oxygen to address his breathing and assist him to a comfortable position to facilitate better oxygenation before contacting the physician. Placing the client in the Trendelenburg position is not recommended in this situation as it may worsen a potential pulmonary embolism by increasing venous return. Contacting the physician for antibiotics is not the priority as the immediate concern is addressing the breathing difficulty. Decreasing the IV rate is not indicated in this situation where the client is experiencing respiratory distress and needs oxygen therapy.

2. What does an anti-kickback statute prevent?

• A. It prevents healthcare workers from providing food or hosting parties to celebrate special occasions at work.
• B. It promotes thorough and complete documentation when a client becomes injured.
• C. It forbids giving or accepting gifts to promote or provide referrals for certain services.
• D. It prevents physicians from ordering treatments that may require nursing care beyond the usual amount.

Correct answer: C

Rationale: An anti-kickback statute aims to prevent healthcare providers, clients, consultants, or related organizations from giving or accepting gifts to reward others for referrals of certain services. Choice A is incorrect because providing food or hosting parties at work is not the primary focus of anti-kickback statutes. Choice B is incorrect as it pertains more to documentation practices rather than gift-giving. Choice D is incorrect as it refers to the scope of physician orders and nursing care, not gift exchanges for referrals. The correct answer, as stated, aligns with the purpose of anti-kickback statutes to prevent improper incentives in healthcare relationships.

3. A client diagnosed with schizophrenia is slow to respond and appears to be listening to unseen others. Which medication should a nurse expect a physician to order to address this type of symptom?

• A. Haloperidol (Haldol) to address the negative symptom
• B. Clonazepam (Klonopin) to address the positive symptom
• C. Risperidone (Risperdal) to address the positive symptom
• D. Clozapine (Clozaril) to address the negative symptom

Correct answer: C

Rationale: The correct medication to address the symptom described, where the client is slow to respond and appears to be listening to unseen others, is Risperidone (Risperdal). Risperidone is an atypical antipsychotic that is commonly used to manage positive symptoms of schizophrenia. Positive symptoms can include hallucinations, delusions, and disorganized thinking. Haloperidol (Haldol) and Clozapine (Clozaril) are typically used for addressing negative symptoms, such as lack of motivation or social withdrawal. Clonazepam (Klonopin) is a benzodiazepine primarily used for anxiety disorders and seizures, not for addressing symptoms of schizophrenia.

4. Which of the following situations might warrant a laboratory magnesium level?

• A. Hyperthyroidism
• B. Arthritis
• C. Ulcerative colitis
• D. Depression

Correct answer: C

Rationale: Ulcerative colitis can lead to symptoms such as abdominal pain, fever, diarrhea, and weight loss. This condition may impact the absorption of certain nutrients, including magnesium. Therefore, patients with chronic gastrointestinal conditions like ulcerative colitis should be screened for electrolyte imbalances related to impaired digestion. Hyperthyroidism, arthritis, and depression do not typically directly affect magnesium levels in the same way as gastrointestinal conditions like ulcerative colitis.

5. Plantar flexion can be prevented with ________________.

• A. foot soaks
• B. foot boards
• C. toenail care
• D. proper shoes

Correct answer: B

Rationale: Plantar flexion, or foot drop, can be prevented with foot boards, special splints, and range of motion exercises. Foot boards help maintain the foot in a neutral position, preventing contractures and deformities. Foot soaks (choice A) may help with foot hygiene but do not directly prevent plantar flexion. Toenail care (choice C) is important for overall foot health but does not prevent plantar flexion. Proper shoes (choice D) are essential for foot support and comfort but do not specifically prevent plantar flexion.

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