Nursing Elites

1. What is pica?

• A. dependency on alcohol
• B. increased iron in the diet
• C. the sickle cell trait
• D. eating ice

Correct answer: D

Rationale: Pica is a disorder characterized by the ingestion of nonfood substances, which can lead to a clinical iron deficiency. It may be the first sign of an underlying issue. Individuals with pica consume a variety of nonfood items such as ice, clay, dirt, or paste. Choice A, dependency on alcohol, is incorrect as it is not related to pica. Choice B, increased iron in the diet, is incorrect because pica involves ingesting nonfood items rather than having an increased intake of iron. Choice C, the sickle cell trait, is unrelated to pica and is therefore incorrect.

2. When a person using over-the-counter nasal decongestant drops experiences unrelieved and worsening nasal congestion, what should be instructed?

• A. switch to a stronger dose of the same medication.
• B. discontinue the medication for a few weeks.
• C. continue taking the same medication, but use it more frequently.
• D. use a combination of medications for better relief.

Correct answer: B

Rationale: When a person using over-the-counter nasal decongestant drops experiences unrelieved and worsening nasal congestion, it is crucial to discontinue the medication for a few weeks. Prolonged use of decongestant drops can lead to rebound congestion, which is relieved by stopping the medication for a period of time. Nasal congestion occurs due to various factors like infection, inflammation, or allergy, leading to swelling of the nasal cavity. Nasal decongestants work by stimulating alpha-adrenergic receptors, causing vasoconstriction and shrinking of nasal mucous membranes. However, prolonged use can result in vasodilation, worsening nasal congestion. Switching to a stronger dose of the same medication is not recommended as it can exacerbate the issue. Continuing the same medication more frequently or using a combination of medications are also not advised and may lead to side effects. Educating individuals on proper decongestant use and potential risks of prolonged usage is essential, especially for those with specific health conditions.

3. After an escharotomy of the forearm, what is the priority nursing assessment for the client who has returned to your unit?

• A. Infection
• B. Incision
• C. Pain
• D. Tissue perfusion

Correct answer: D

Rationale: The correct answer is "Tissue perfusion." After an escharotomy, the priority assessment is to ensure adequate tissue perfusion to the affected limb. Escharotomy is performed to relieve circulatory compromise by cutting through the eschar, so monitoring tissue perfusion is crucial to assess the effectiveness of the procedure and prevent complications. Assessing for infection is important but comes after ensuring adequate tissue perfusion. Checking the incision is necessary but assessing tissue perfusion takes precedence. Pain assessment is important but not the priority compared to assessing tissue perfusion to prevent ischemic complications.

4. A nurse is assigned to do pre-operative teaching on a blind patient who is scheduled for surgery the following morning. What teaching strategy would best fit the situation?

• A. Verbal teaching in short sessions throughout the day
• B. Provide a pre-operative booklet in Braille
• C. Provide an audio recording for the client
• D. Have the blind patient's family member assist with the instruction

Correct answer: A

Rationale: For a blind patient scheduled for surgery the following morning, the best teaching strategy would be verbal teaching in short sessions throughout the day. Providing information in smaller amounts makes it easier to retain, and one-on-one teaching is most effective. Choice B, providing a pre-operative booklet in Braille, may not be as practical for last-minute teaching. Choice C, providing an audio recording, may not allow for immediate interaction and clarification. Choice D, having a family member instruct the patient, may not ensure the accuracy and clarity of the information provided.

5. 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.

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