Nursing Elites

1. The healthcare provider is preparing to administer atropine, an anticholinergic, to a client scheduled for a cholecystectomy. The client asks the provider to explain the reason for the prescribed medication. What response is best for the provider to provide?

• A. To increase gastric motility.
• B. To decrease the risk of bradycardia during surgery.
• C. To reduce secretions.
• D. To prevent nausea and vomiting.

Correct answer: B

Rationale: Atropine, an anticholinergic medication, is used preoperatively to prevent bradycardia by increasing the automaticity of the sinoatrial node during surgical anesthesia. Choice A is incorrect because atropine does not affect gastric motility. Choice C is incorrect as atropine is not primarily used to reduce secretions. Choice D is also incorrect because preventing nausea and vomiting is not the primary purpose of administering atropine in this context.

2. The nurse is caring for a client with Addison's disease. Which finding requires immediate intervention?

• A. Hyperpigmentation of the skin.
• B. Low blood pressure.
• C. Nausea and vomiting.
• D. Hypoglycemia.

Correct answer: B

Rationale: Low blood pressure in a client with Addison's disease requires immediate intervention as it can indicate an Addisonian crisis, a life-threatening condition that necessitates prompt treatment. Hyperpigmentation of the skin is a characteristic finding in Addison's disease but does not require immediate intervention. Nausea and vomiting can be managed symptomatically in Addison's disease. While hypoglycemia needs attention, it is not the most critical finding requiring immediate intervention in this context.

3. A client with a history of heart failure is admitted with severe dyspnea. Which intervention should the nurse implement first?

• A. Administer oxygen at 2 liters per minute via nasal cannula.
• B. Place the client in a high Fowler's position.
• C. Obtain a 12-lead electrocardiogram (ECG).
• D. Administer intravenous furosemide (Lasix).

Correct answer: B

Rationale: The correct answer is to place the client in a high Fowler's position first. This intervention helps improve breathing and oxygenation in clients with severe dyspnea, including those with heart failure. Elevating the head of the bed reduces the work of breathing and enhances lung expansion. Administering oxygen, obtaining an ECG, and administering furosemide are important interventions in the management of heart failure, but placing the client in a high Fowler's position is the priority to address the immediate need for improved breathing and oxygenation.

4. The healthcare provider provides teaching to a group of evacuees in a mass casualty center after a natural flooding disaster. Which information should the healthcare provider include in the teaching plan? (select one that does not apply.)

• A. wash all fruits and vegetables thoroughly in running tap water
• B. identify all sexual contacts since the evacuation process
• C. take all doses of prophylactic prescriptions for diarrhea
• D. clean hands using soap, clean water, or waterless antibacterial solutions

Correct answer: B

Rationale: In the aftermath of a flooding disaster, educating evacuees on proper hygiene practices like washing fruits and vegetables, taking prophylactic prescriptions, and practicing hand hygiene is crucial to prevent the spread of diseases. Option B, identifying sexual contacts, is not relevant to preventing post-disaster health risks and should not be included in the teaching plan.

5. While screening all children in the third grade for head lice, the school nurse observes that one girl has a brownish thickening on her neck. Which action should the nurse take in response to this finding?

• A. review the child's medical folder for a list of allergies
• B. instruct the child's parents to begin treatment
• C. advise the child's parents to obtain a medical evaluation of the child
• D. none of the above

Correct answer: C

Rationale: The correct action for the nurse to take is to advise the child's parents to obtain a medical evaluation of the child. This is important because a medical professional needs to properly diagnose and treat the brownish thickening observed on the child's neck. Reviewing the child's medical folder for allergies (Choice A) is not appropriate in this situation as it does not address the specific concern. Instructing the child's parents to begin treatment (Choice B) without a proper diagnosis can be harmful and ineffective. Choosing 'none of the above' (Choice D) is not the best option when a potential health issue is identified; seeking a medical evaluation is the most appropriate course of action.

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