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: Social support systems involve external sources of support like call-in help lines, emotional assistance from others, and community support groups. These external resources provide individuals with assistance and comfort. Coping skills and verbalization for anger management are personal strategies that individuals use to manage emotions internally. While these skills can be beneficial, they are not considered part of external social support systems.

2. What is the first exercise that should be performed by a client who had a mastectomy?

• A. Walking the hand up the wall
• B. Sweeping the floor
• C. Combing her hair
• D. Squeezing a ball

Correct answer: D

Rationale: The correct answer is D: Squeezing a ball. The first exercise that should be done by a client with a mastectomy is squeezing a ball. This helps in regaining strength and mobility in the affected area. Choices A, B, and C are incorrect as they are not typically the initial exercises recommended post-mastectomy. Walking the hand up the wall, sweeping the floor, and combing hair are activities that may be introduced later in the rehabilitation process.

3. When discussing the patterns of use of alcohol and other drugs, which piece of information should the nurse include?

• A. Lifetime prevalence and intensity of alcohol use are greater in men than in women.
• B. Caucasians report higher levels of alcohol use than African Americans or Hispanics.
• C. Overuse of alcohol and other drugs increases into the mid-20s, then levels off and decreases with age.
• D. Heavy use is more common in lower socioeconomic groups due to affordability.

Correct answer: C

Rationale: The correct answer is that overuse of alcohol and other drugs increases into the mid-20s, then levels off and decreases with age. Recent research indicates that alcohol and illicit drug use tends to rise into the mid-20s and then decline with age. Choices A and B are incorrect because lifetime prevalence and intensity of alcohol use are greater in men than in women, and Caucasians do not report higher levels of alcohol use compared to African Americans or Hispanics. Choice D is incorrect because heavy use is more common in lower socioeconomic groups due to factors like stress, coping mechanisms, and availability, not just affordability.

4. The nurse is caring for a client with epilepsy who is being treated with carbamazepine (Tegretol). Which laboratory value might indicate a serious side effect of this drug?

• A. Uric acid of 5 mg/dL
• B. Hematocrit of 33%
• C. WBC 2,000 per cubic millimeter
• D. Platelets 150,000 per cubic millimeter

Correct answer: C

Rationale: Carbamazepine (Tegretol) can suppress the bone marrow, leading to a decrease in the white blood cell count. A laboratory value of WBC 2,000 per cubic millimeter indicates a serious side effect of the drug. Choices A and D are within normal limits, while choice B is at the lower limit of normal. Therefore, choices A, B, and D are incorrect.

5. Following the change of shift report, when can or should the nurse alter or modify the plan?

• A. halfway through the shift
• B. at the end of the shift before handing over
• C. when needs change
• D. after the top-priority tasks have been completed

Correct answer: C

Rationale: The correct answer is 'when needs change.' The nurse should be flexible and adjust the plan as necessary when the needs of the patients change. This ensures that care is provided effectively and efficiently. Choices A, B, and D are incorrect because altering the plan based on time intervals, solely at the end of the shift, or after completing top-priority tasks may not align with the current needs of the patients.

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