Nursing Elites

1. While the client is receiving quinidine, the nurse should monitor the ECG for:

• A. Peaked P wave
• B. Elevated ST segment
• C. Inverted T wave
• D. Prolonged QT interval

Correct answer: D

Rationale: Quinidine can cause widened Q-T intervals and heart block, leading to a prolonged QT interval on the ECG. Other signs of myocardial toxicity associated with quinidine include notched P waves and widened QRS complexes. Common side effects of quinidine include diarrhea, nausea, and vomiting, while less common effects may include tinnitus, vertigo, headache, visual disturbances, and confusion. Monitoring for a prolonged QT interval is crucial due to the potential risk of serious arrhythmias. Choices A, B, and C are not typically associated with the use of quinidine and are therefore incorrect in this context.

2. A 24-year-old female client is scheduled for surgery in the morning. What is the primary responsibility of the nurse?

• A. Taking the vital signs
• B. Obtaining the permit
• C. Explaining the procedure
• D. Checking the lab work

Correct answer: A

Rationale: The primary responsibility of the nurse is to take the vital signs before any surgery. This action helps assess the client's baseline condition and identify any abnormalities that need addressing before the procedure. Obtaining the permit (choice B) is typically handled by administrative staff, explaining the procedure (choice C) is usually done by the healthcare provider performing the surgery, and checking the lab work (choice D) is often part of the pre-operative assessment conducted by the healthcare provider. Therefore, in this context, these actions are not the primary responsibility of the nurse.

3. A man expresses surprise that his wife has become very withdrawn during hospitalization for pneumonia.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.

4. In the context of milieu therapy, what is its primary purpose?

• A. exploring the client's perception of reality
• B. enhancing social interaction abilities
• C. addressing maladaptive behaviors
• D. providing routine daily experiences

Correct answer: D

Rationale: Milieu therapy aims to provide routine daily experiences to clients. By offering a structured and predictable environment, it helps individuals feel safe and secure, reducing disruptive behaviors. Exploring the client's perception of reality (choice A) may be part of therapy but not the primary focus. Enhancing social interaction abilities (choice B) and addressing maladaptive behaviors (choice C) are important aspects of therapy but not the primary purpose of milieu therapy.

5. 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.

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