Nursing Elites

1. The nurse is aware that norepinephrine is secreted by which endocrine gland?

• A. The pancreas
• B. The adrenal cortex
• C. The adrenal medulla
• D. The anterior pituitary gland

Correct answer: C

Rationale: The correct answer is C: The adrenal medulla. Norepinephrine is secreted by the adrenal medulla and is involved in the body's 'fight or flight' response. The pancreas (choice A) secretes insulin and glucagon, not norepinephrine. The adrenal cortex (choice B) secretes hormones like cortisol and aldosterone, but not norepinephrine. The anterior pituitary gland (choice D) secretes various hormones like growth hormone and thyroid-stimulating hormone, but not norepinephrine.

2. The client is four hours post-operative abdominal aortic aneurysm repair. Which nursing intervention should be implemented for this client?

• A. Assist the client in ambulating
• B. Assess the client’s bilateral pedal pulses
• C. Maintain a continuous IV heparin drip
• D. Provide clear liquids to the client

Correct answer: B

Rationale: Assessing the client’s bilateral pedal pulses is crucial at this point to monitor the perfusion to the lower extremities after abdominal aortic aneurysm repair surgery. Ambulation (Choice A) may be appropriate but should be guided by the assessment findings. Maintaining a continuous IV heparin drip (Choice C) is not typically indicated post-operatively for this type of surgery. Providing clear liquids (Choice D) may not be suitable immediately after the surgery, as the client needs time to recover before resuming oral intake.

3. When is aspirin most effective when taken?

• A. On an empty stomach with cold water
• B. On a full stomach after a meal
• C. With a glass of fruit juice
• D. First thing in the morning

Correct answer: A

Rationale: Aspirin is best absorbed on an empty stomach to maximize its effectiveness. Taking it with cold water helps in its quick absorption. Option B is incorrect because taking aspirin on a full stomach can delay its absorption. Option C is incorrect as fruit juice may not provide the ideal conditions for absorption. Option D is incorrect as taking aspirin first thing in the morning may not ensure an empty stomach.

4. The nurse had developed a close relationship with the family of a client who is dying. Which nursing intervention(s) are most appropriate in dealing with the family?

• A. Encouraging family discussion of feelings
• B. Accepting the family’s experience of anger
• C. Facilitating the use of spiritual practices identified by the family
• D. All of the above

Correct answer: D

Rationale: When a nurse has developed a close relationship with a dying client's family, it is crucial to provide comprehensive support. Encouraging family discussion of feelings helps them express their emotions and concerns, fostering a sense of relief. Accepting the family's experience of anger without judgment validates their emotions and promotes trust. Facilitating the use of spiritual practices identified by the family acknowledges their beliefs and values, offering comfort and solace. Therefore, all of the above interventions are essential in providing holistic care and support during such a challenging time. Choices A, B, and C each play a vital role in addressing different aspects of the family's emotional and spiritual needs, making option D the correct answer.

5. The client with chronic alcoholism has chronic pancreatitis and hypomagnesemia. What should the nurse assess when administering magnesium sulfate to the client?

• A. Deep tendon reflexes
• B. Arterial blood gases
• C. Skin turgor
• D. Capillary refill time

Correct answer: A

Rationale: The correct answer is A: Deep tendon reflexes. When administering magnesium sulfate to a client with chronic alcoholism, chronic pancreatitis, and hypomagnesemia, the nurse should assess deep tendon reflexes. Magnesium sulfate can depress the central nervous system and decrease deep tendon reflexes, so monitoring them is crucial. Choices B, C, and D are not directly related to the assessment needed when administering magnesium sulfate in this scenario. Arterial blood gases are not typically assessed specifically for magnesium sulfate administration; skin turgor and capillary refill time are more related to hydration status and perfusion, respectively.

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