Nursing Elites

1. People who live in poverty are most likely to obtain health care from:

• A. their primary care physician (family doctor)
• B. a neighborhood clinic
• C. specialists
• D. Emergency Departments or urgent care centers

Correct answer: D

Rationale: Individuals living in poverty often face barriers to accessing regular healthcare services, leading them to utilize Emergency Departments or urgent care centers as their primary source of healthcare. These facilities provide immediate care without the need for appointments or insurance, making them more accessible to those in poverty. While primary care physicians and neighborhood clinics are essential for preventive care, individuals in poverty may have difficulty accessing these services due to financial constraints or lack of insurance. Specialists typically require referrals and may not be easily accessible to individuals without stable healthcare coverage. Therefore, Emergency Departments or urgent care centers are the most likely healthcare option for people living in poverty.

2. A wrong committed by one person against another (or against the property of another) that might result in a civil trial is:

• A. a tort
• B. a crime
• C. a misdemeanor
• D. a felony

Correct answer: B

Rationale: A tort is a civil wrong committed by one person against another person (or against the property of another) that might result in civil trials. Unlike crimes, which are considered wrongs against the public, torts are personal wrongs. Misdemeanors are crimes punishable with fines or imprisonment for less than one year, whereas felonies are serious crimes punishable by imprisonment for more than one year in a State or Federal penitentiary. Therefore, the correct answer is a tort as it aligns with the definition of a civil wrong that leads to potential civil trials, distinguishing it from crimes, misdemeanors, and felonies.

3. The LPN has been asked to help a client taking Risperdal with activities of daily living in the morning. Which of these tasks is most likely to be potentially impacted by this medication?

• A. eating breakfast
• B. drinking fluids
• C. getting out of bed to use the bathroom
• D. brushing teeth

Correct answer: C

Rationale: The correct answer is 'getting out of bed to use the bathroom.' Risperdal can cause orthostatic hypotension, leading to a drop in blood pressure when changing positions from lying down to standing up. This effect increases the risk of falls, emphasizing the need to assist the client with this task to prevent potential harm. Choices A, B, and D are less likely to be directly impacted by the medication, unlike the significant risk of orthostatic hypotension associated with changing positions.

4. A nurse reviewing a client's record notes that the result of the client's latest Snellen chart vision test was 20/80. The nurse interprets the client's results in which way?

• A. The client is legally blind.
• B. The client has normal vision.
• C. The client can read at a distance of 20 feet what a client with normal vision can read at 80 feet.
• D. The client can read at a distance of 80 feet what a client with normal vision can read at 20 feet.

Correct answer: D

Rationale: When interpreting visual acuity testing results using the Snellen chart, the recorded numeric fraction represents the distance the client is standing from the chart and the distance a normal eye could read that particular line. A reading of 20/80 means that the client can read at 20 feet what a client with normal vision can read at 80 feet. This indicates visual impairment but does not meet the criteria for legal blindness, which is defined as best-corrected vision in the better eye of 20/200 or worse. Normal visual acuity is 20/20. Therefore, the correct interpretation is that the client can read at a distance of 80 feet what a client with normal vision can read at 20 feet. Choice A is incorrect because 20/80 does not meet the criteria for legal blindness. Choice B is incorrect as the client's vision is impaired. Choice C is incorrect because it reverses the interpretation of the fraction.

5. The physician orders the antibiotics ampicillin (Omnipen) and gentamicin (Garamycin) for a newly admitted client with an infection. The nurse should:

• A. administer both medications simultaneously
• B. give the medications sequentially, and flush well between them
• C. ask the physician or pharmacy which medication to give first and how long to wait before giving the other drug
• D. start one medication now and begin the other medication in 2-4 hours

Correct answer: B

Rationale: The correct answer is to give the medications sequentially and flush well between them. Ampicillin has a pH of 8-10, while gentamicin has a pH of 3-5.5, making them incompatible when given together. Flushing well between drugs is necessary to prevent any potential interactions. Option A is incorrect because administering both medications simultaneously can lead to incompatibility issues. Option C is incorrect because the nurse should already be aware of the correct administration sequence and not need to consult the physician or pharmacy each time. Option D is incorrect because delaying the second medication by several hours can slow down the treatment of the client's infection, which is not ideal in this scenario.

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