Nursing Elites

1. The nurse understands that which characteristics are of anthrax? Select all that apply.

• A. Cutaneous lesions become a black eschar and flu-like symptoms are a sign of pulmonary anthrax
• B. Cutaneous lesions become a black eschar
• C. Gastrointestinal anthrax causes blood anthrax
• D. Flu-like symptoms are a sign of pulmonary anthrax

Correct answer: A

Rationale: The correct characteristics of anthrax are that cutaneous anthrax causes black eschar lesions, and flu-like symptoms are typical of pulmonary anthrax. Choice B is incorrect because it only includes information about cutaneous anthrax lesions but doesn't cover the flu-like symptoms of pulmonary anthrax. Choice C is incorrect as gastrointestinal anthrax does not cause 'blood anthrax,' it causes symptoms like severe abdominal pain, vomiting, and diarrhea. Choice D is incorrect as flu-like symptoms are associated with pulmonary anthrax, not with gastrointestinal anthrax.

2. The nurse enters a client’s room and the client is demanding release from the hospital. The nurse reviews the client’s record and noted that the client was admitted 2 days ago for treatment of an anxiety disorder, and the admission was voluntary. Which intervention should the nurse initiate first?

• A. Telephone the client’s family and have them persuade the client to stay
• B. Have the client read and sign all the appropriate self-discharge papers
• C. Explain to the client that he cannot leave because he asked for treatment
• D. Notify the client’s healthcare provider of the client’s stated intent to leave the hospital

Correct answer: D

Rationale: The correct intervention for the nurse to initiate first is to notify the client’s healthcare provider of the client’s stated intent to leave the hospital. This action is crucial as it ensures that the client’s care and safety are appropriately managed. Option A is not the best choice as involving the family to persuade the client may not address the client's underlying concerns. Option B is incorrect because having the client sign self-discharge papers without further assessment is not appropriate. Option C is also incorrect as the client's request for treatment does not prevent them from leaving if they are deemed competent to make that decision.

3. A patient with Crohn’s disease is experiencing diarrhea. Which dietary recommendation is appropriate?

• A. High-fiber diet
• B. Low-residue diet
• C. High-fat diet
• D. High-protein diet

Correct answer: B

Rationale: A low-residue diet is appropriate for a patient with Crohn’s disease experiencing diarrhea because it helps reduce bowel movements and manage symptoms. Choice A, a high-fiber diet, can exacerbate diarrhea in Crohn’s disease due to increased bulk and fermentation in the gut. Choice C, a high-fat diet, may be hard to digest and can worsen symptoms. Choice D, a high-protein diet, can be taxing on the digestive system and may not provide the relief needed for diarrhea in Crohn’s disease.

4. What intervention would be most important for the nurse to implement for the client with a left nephrectomy?

• A. Assess the intravenous fluids for rate and volume
• B. Change the surgical dressing daily at the same time
• C. Monitor the client’s medication levels daily
• D. Monitor the percentage of each meal eaten

Correct answer: A

Rationale: The correct answer is A: Assess the intravenous fluids for rate and volume. After a nephrectomy, monitoring intravenous fluids is crucial to ensure proper hydration and kidney function. Choice B is incorrect because changing the surgical dressing daily is important but not the most critical intervention. Choice C is incorrect as monitoring medication levels daily may be necessary but is not the priority after a nephrectomy. Choice D is irrelevant to the immediate postoperative care needed after a nephrectomy.

5. Which nursing instruction should the nurse discuss with the client who is receiving glucocorticoids for Addison’s disease?

• A. Discuss the importance of tapering medications when discontinuing medication
• B. Explain that the dose will need to be decreased during times of stress or infection
• C. Instruct the client to take medication on an empty stomach with a glass of water
• D. Encourage the client to wear a MedicAlert bracelet and carry a card in the wallet

Correct answer: A

Rationale: The correct answer is to discuss the importance of tapering medications when discontinuing medication. Tapering glucocorticoids is crucial to prevent adrenal insufficiency, which can occur if the medication is stopped abruptly. Choice B is incorrect because it focuses on adjustments during stress or infection, not discontinuation. Choice C is unrelated to the management of glucocorticoids. Choice D is important for emergency identification but is not directly related to medication management.

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