Nursing Elites

1. Which client should the nurse see first?

• A. Recurring crushing chest pain
• B. Needing an IV for surgery in 5 minutes
• C. Needing PCA morphine for pain control post-hysterectomy
• D. Waiting to get back to bed after sitting in a chair for 30 minutes

Correct answer: A

Rationale: The client presenting with recurring crushing chest pain should be seen first as this symptom could indicate a myocardial infarction (MI), which is a life-threatening condition requiring immediate attention. Assessing and managing potential cardiac issues take priority over other concerns like needing an IV for surgery, pain control post-hysterectomy, or assistance with mobility. While all clients require care, addressing the chest pain promptly is crucial to ensure the client's safety and well-being.

2. Which of the following microorganisms is easily transmitted from client to client on the hands of healthcare workers?

• A. mycobacterium tuberculosis
• B. clostridium tetani
• C. staphylococcus aureus
• D. human immunodeficiency virus

Correct answer: C

Rationale: The correct answer is staphylococcus aureus. Staphylococcus aureus microorganisms are ubiquitous and easily transmitted by healthcare workers who fail to conduct routine hand washing between clients. Staphylococcus aureus can reside on the skin and be transferred from one client to another if proper hand hygiene is not practiced. Mycobacterium tuberculosis is mainly transmitted through the airborne route, clostridium tetani is usually acquired through exposure to soil or dirt contaminated with tetanus spores, and human immunodeficiency virus is not easily transmitted through casual contact or on the hands of healthcare workers.

3. Which of the following diseases or conditions is least likely to be associated with an increased potential for bleeding?

• A. metastatic liver cancer
• B. gram-negative septicemia
• C. pernicious anemia
• D. iron-deficiency anemia

Correct answer: C

Rationale: Pernicious anemia is least likely to be associated with an increased potential for bleeding compared to the other conditions listed. Pernicious anemia is a condition resulting from vitamin B12 deficiency due to the absence of intrinsic factor, necessary for B12 absorption. While pernicious anemia can lead to neurological issues, it is not directly linked to an increased risk of bleeding. Metastatic liver cancer can cause liver dysfunction leading to coagulopathy, gram-negative septicemia can result in disseminated intravascular coagulation (DIC), and iron-deficiency anemia can lead to microcytic hypochromic red blood cells, increasing the risk of bleeding. Therefore, pernicious anemia is the least likely to be associated with an increased potential for bleeding out of the options provided.

4. A patient who has delivered an 8.2 lb. baby boy 3 days ago via c-section, reports white patches on her breast that aren't going away. Which of the following medications may be necessary?

• A. Nystatin
• B. Atropine
• C. Amoxil
• D. Lortab

Correct answer: A

Rationale: The patient is likely experiencing thrush, a fungal infection, which can present as white patches on the breast that persist. Nystatin is an antifungal medication commonly used to treat thrush. Therefore, the correct answer is Nystatin. Atropine is not indicated for this condition and is used for different purposes. Amoxil is an antibiotic and would not be effective against a fungal infection like thrush. Lortab is a pain medication and is not appropriate for treating thrush.

5. Which of the following conditions places a client at risk for developing cirrhosis?

• A. Type I diabetes
• B. Alcoholism
• C. Leukemia
• D. Glaucoma

Correct answer: B

Rationale: Alcoholism places a client at risk for developing cirrhosis due to the liver damage caused by excessive alcohol consumption. Type I diabetes, leukemia, and glaucoma are not directly associated with cirrhosis. While diabetes can lead to other health complications, it does not directly cause cirrhosis. Leukemia is a type of blood cancer that does not affect the liver in a way that leads to cirrhosis. Glaucoma is an eye condition that has no direct link to cirrhosis.

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