Nursing Elites

1. When caring for a patient with Parkinson's Disease, which of the following practices would not be included in the care plan?

• A. Decrease the calorie content of daily meals to avoid weight gain
• B. Allow the patient extra time to respond to questions and perform ADLs
• C. Use thickened liquids and a soft diet
• D. Encourage the patient to hold the spoon when eating

Correct answer: A

Rationale: The correct answer is to decrease the calorie content of daily meals to avoid weight gain. Patients with Parkinson's Disease often experience dysphagia (difficulty swallowing) and muscle rigidity, which can lead to weight loss. Therefore, increasing calorie intake is essential to meet their nutritional needs. Choice A is incorrect because reducing calories can worsen malnutrition in these patients. Choices B, C, and D are appropriate interventions for patients with Parkinson's Disease. Allowing extra time for tasks, using thickened liquids and a soft diet for swallowing difficulties, and encouraging self-feeding promote independence and safety in eating.

2. To prevent a Valsalva maneuver in a client recovering from an acute myocardial infarction, the nurse would:

• A. Assist the client in using the bedside commode
• B. Administer stool softeners daily as prescribed
• C. Administer antidysrhythmics PRN as prescribed
• D. Maintain the client on strict bed rest

Correct answer: B

Rationale: Administering stool softeners daily as prescribed is essential to prevent straining during defecation, which can lead to a Valsalva maneuver. Straining can increase intra-abdominal pressure, hinder venous return, and elevate blood pressure, risking cardiac complications in a client recovering from a heart attack. Using a bedside commode might be useful to minimize exertion during toileting but does not directly address the risk of a Valsalva maneuver. Administering antidysrhythmics PRN is not the primary intervention for preventing a Valsalva maneuver; these medications are used to manage dysrhythmias if they occur. Keeping the client on strict bed rest is not the best option as early mobilization is encouraged in post-myocardial infarction recovery to prevent complications such as deep vein thrombosis and muscle weakness.

3. Which action will the nurse include in the plan of care for a patient who has been diagnosed with chronic hepatitis B?

• A. Advise limiting alcohol intake to 1 drink daily
• B. Schedule for liver cancer screening every 6 months
• C. Initiate administration of the hepatitis C vaccine series
• D. Monitor anti-hepatitis B surface antigen (anti-HBs) levels annually

Correct answer: B

Rationale: Patients diagnosed with chronic hepatitis B are at a higher risk for developing liver cancer. Therefore, it is essential to schedule them for liver cancer screening every 6 to 12 months to detect any potential malignancies at an early stage. Advising patients to limit alcohol intake is crucial as alcohol can exacerbate liver damage; thus, patients with chronic hepatitis B are advised to completely avoid alcohol. Administering the hepatitis C vaccine is irrelevant for a patient diagnosed with chronic hepatitis B since it is a different virus. Monitoring anti-hepatitis B surface antigen (anti-HBs) levels annually is not necessary as the presence of anti-HBs indicates a past hepatitis B infection or vaccination, and it does not require regular monitoring.

4. When taking a patient’s history, she mentions being depressed and dealing with an anxiety disorder. Which of the following medications would the patient most likely be taking?

• A. Amitriptyline (Elavil)
• B. Calcitonin
• C. Pergolide mesylate (Permax)
• D. Verapamil (Calan)

Correct answer: A

Rationale: The correct answer is Amitriptyline (Elavil) as it is a tricyclic antidepressant commonly used to treat symptoms of depression and anxiety disorders. Amitriptyline works by increasing the levels of certain neurotransmitters in the brain to improve mood. Choices B, C, and D are incorrect. Calcitonin is a hormone used in the treatment of osteoporosis; Pergolide mesylate is a dopamine agonist used in Parkinson's disease; Verapamil is a calcium channel blocker used to treat high blood pressure and certain heart conditions, not mental health disorders.

5. A 15-year-old female who ingested 15 tablets of maximum strength acetaminophen 45 minutes ago is rushed to the emergency department. Which of these orders should the nurse do first?

• A. Gastric lavage
• B. Administer acetylcysteine (Mucomyst) orally
• C. Start an IV Dextrose 5% with 0.33% normal saline to keep the vein open
• D. Have the patient drink activated charcoal mixed with water

Correct answer: A

Rationale: Acetaminophen overdose is extremely toxic to the liver causing hepatotoxicity. Early symptoms of hepatic damage include nausea, vomiting, abdominal pain, and diarrhea. If not treated immediately, hepatic necrosis occurs and may lead to death. Removing as much of the drug as possible is the first step in treatment for acetaminophen overdose, this is best done through gastric lavage. Gastric lavage (irrigation) and aspiration consist of flushing the stomach with fluids and then aspirating the fluid back out. This procedure is done in life-threatening cases such as acetaminophen toxicity and only if less than one (1) hour has occurred after ingestion.

Similar Questions