Nursing Elites

1. Social support systems include all of the following except:

• A. call-in help lines
• B. emotional assistance provided by others
• C. community support groups
• D. use of coping skills and verbalization for anger management

Correct answer: D

Rationale: The correct answer is the use of coping skills and verbalization for anger management. Social support systems involve external sources of support from others or the community. Call-in help lines, emotional assistance provided by others, and community support groups all represent social support systems where individuals can seek help and assistance from outside sources. On the other hand, the use of coping skills and verbalization for anger management refers to individual strategies rather than external social support.

2. How can medication bound to protein affect drug availability?

• A. enhanced drug availability
• B. rapid distribution of the drug to receptor sites
• C. less availability to produce desired medicinal effects
• D. increased metabolism of the drug by the liver

Correct answer: C

Rationale: Medication bound to protein reduces the availability of the drug to produce desired medicinal effects because only unbound drugs can effectively bind to active receptor sites. When a drug is bound to protein, it cannot bind with receptor sites, limiting its therapeutic impact. Choice A is incorrect because drug availability is reduced when it is bound to protein. Choice B is incorrect as rapid distribution to receptor sites is not possible if the drug is bound to protein and cannot bind with receptors. Choice D is incorrect as metabolism does not increase when the drug is bound to protein; the liver first needs to separate the drug from the protein before metabolism can occur.

3. A client visits the clinic after the death of a parent. Which statement made by the client's sister signifies abnormal grieving?

• A. "My sister still has episodes of crying, and it's been 3 months since Daddy died."?
• B. "Sally seems to have forgotten the bad things that Daddy did in his lifetime."?
• C. "She really had a hard time after Daddy's funeral. She said that she had a sense of longing."?
• D. "Sally has not been sad at all about Daddy's death. She acts like nothing has happened."?

Correct answer: D

Rationale: Abnormal grieving is often characterized by a lack of sadness or acknowledgment of the loss. In this scenario, the statement 'Sally has not been sad at all about Daddy's death. She acts like nothing has happened' indicates abnormal grieving as it suggests a lack of emotional response or denial of the death. On the other hand, choices A, B, and C all describe normal grieving reactions: crying episodes, selective memory of the deceased, and feelings of longing after the funeral. These responses are typical in the grieving process. Therefore, choice D is the correct answer, highlighting a potential abnormality in the grieving process.

4. A client is given an opiate drug for pain relief following general anesthesia. The client becomes extremely somnolent with respiratory depression. The physician is likely to order the administration of:

• A. naloxone (Narcan)
• B. labetalol (Normodyne)
• C. neostigmine (Prostigmin)
• D. thiothixene (Navane)

Correct answer: A

Rationale: The correct answer is naloxone (Narcan). Naloxone is an opioid antagonist used to reverse opioid-induced respiratory depression and somnolence. In this scenario, the client's extreme somnolence and respiratory depression suggest an opioid overdose, making naloxone the appropriate choice to counteract these effects. Labetalol (Normodyne) is a nonselective beta-blocker used to treat hypertension, not opioid overdose. Neostigmine (Prostigmin) is a cholinesterase inhibitor used to reverse neuromuscular blockade, not opioid-induced respiratory depression. Thiothixene (Navane) is an antipsychotic medication used to treat schizophrenia and is not indicated for opioid overdose.

5. Which nurse should be assigned to care for the postpartal client with preeclampsia?

• A. The nurse with 2 weeks of experience on the postpartum unit
• B. The nurse with 3 years of experience in labor and delivery
• C. The nurse with 10 years of experience in surgery
• D. The nurse with 1 year of experience in the neonatal intensive care unit

Correct answer: B

Rationale: The nurse with 3 years of experience in labor and delivery (answer B) should be assigned to care for the postpartal client with preeclampsia. This nurse has the most relevant experience and knowledge of possible complications associated with preeclampsia due to their background in labor and delivery. Assigning a nurse with only 2 weeks of experience on the postpartum unit (answer A) would not be suitable for handling the complexities of caring for a client with preeclampsia. Nurses with experience in surgery (answer C) or the neonatal intensive care unit (answer D) lack the specific expertise needed for managing a postpartal client with preeclampsia, making them unsuitable choices for this assignment.

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