Nursing Elites

1. The LPN is caring for a client admitted for acute pancreatitis. Which of these medications would be the least appropriate for pain management?

• A. Tylenol
• B. Tramadol
• C. Codeine
• D. Morphine

Correct answer: D

Rationale: Morphine is the least appropriate choice for pain management in pancreatitis due to its potential to cause spasms in the Sphincter of Oddi, which can worsen the client's condition by potentially obstructing the pancreatic duct. Tylenol, Tramadol, and Codeine are more suitable options for pain management in acute pancreatitis as they do not carry the same risk of exacerbating the condition by causing spasms in the Sphincter of Oddi.

2. The nurse is caring for a 4-year-old client. What is the most appropriate pain scale for the nurse to use during the assessment?

• A. McGill Pain Scale
• B. FLACC Pain Scale
• C. CRIES Pain Scale
• D. Wong-Baker Pain Scale

Correct answer: D

Rationale: The correct answer is the Wong-Baker Pain Scale. This scale is specifically designed for pediatric clients, including children as young as 3 years old, making it the most appropriate choice for a 4-year-old. It utilizes a simple visual scale with facial expressions that children can easily understand and use to express their pain levels. The FLACC and CRIES Pain Scales are also used for pediatric clients but are more focused on non-verbal cues and specific populations like infants or critically ill children. The McGill Pain Scale, on the other hand, is more complex and uses descriptive words, making it more suitable for adult clients who can better articulate their pain experiences.

3. The nurse has a client who is being transferred to another floor right around change of shift. Which of the following actions is least appropriate?

• A. Inform the staff on the other floor of any unresolved issues with the client.
• B. Ask the charge nurse if overtime would be permitted to complete the client's transfer to the other floor.
• C. Ask the new nurse to take care of the transfer since the client's medical record has all of the information, and a report should not be needed.
• D. Complete the transfer paperwork before the client is transferred.

Correct answer: C

Rationale: The least appropriate action in this scenario is to ask the new nurse to take care of the transfer without providing a full handoff of care. It is crucial to ensure a safe handoff during the transfer to maintain continuity of care and patient safety. Informing the staff on the other floor of any unresolved issues with the client (Choice A) is important for the client's well-being as it helps in providing comprehensive care. Asking the charge nurse about overtime (Choice B) demonstrates consideration for completing the task effectively, but it should not take precedence over ensuring a proper handoff. Completing the transfer paperwork before the client is transferred (Choice D) is necessary to ensure all documentation is in order, but it should be done in conjunction with providing a thorough handoff of care to the new nurse.

4. Which of the following methods of contraception is able to reduce the transmission of HIV and other STDs?

• A. intrauterine device (IUD)
• B. Norplant
• C. oral contraceptives
• D. vaginal sponge

Correct answer: D

Rationale: The correct answer is the vaginal sponge. The vaginal sponge is a barrier method of contraception that, when used with foam or jelly contraception, reduces the transmission of HIV and other STDs, as well as reducing the risk of pregnancy. Intrauterine devices (IUDs), Norplant, and oral contraceptives can prevent pregnancy but not the transmission of HIV and STDs. Clients using the contraceptive methods in Choices A, B, and C should be counseled to use a chemical or barrier contraceptive to decrease the transmission of HIV or STDs.

5. A client is taught about healthy dietary measures and the MyPlate food plan. How many of his grains should be whole grains according to the MyPlate food plan?

• A. One-quarter
• B. One-third
• C. One-half
• D. Two-thirds

Correct answer: C

Rationale: The correct answer is 'One-half.' According to the MyPlate food plan, at least half of the grains consumed daily should be whole grains. This ensures a well-balanced and healthy diet. Choices A, B, and D are incorrect because they do not align with the dietary recommendation provided by the MyPlate food plan. One-quarter, one-third, and two-thirds do not represent the appropriate proportion of whole grains as advised by the plan, which emphasizes the importance of including a significant portion of whole grains in one's diet.

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