Nursing Elites

1. Which disorder is characterized by demyelination of neurons in the central nervous system?

• A. Multiple sclerosis
• B. Parkinson's disease
• C. Alzheimer's disease
• D. Huntington's disease

Correct answer: A

Rationale: Multiple sclerosis is the correct answer. It is an autoimmune disease that specifically targets and damages the myelin sheath surrounding neurons in the central nervous system. This demyelination disrupts the transmission of nerve signals and leads to a variety of neurological symptoms. Parkinson's disease (Choice B), Alzheimer's disease (Choice C), and Huntington's disease (Choice D) are neurodegenerative disorders that do not primarily involve demyelination of neurons in the CNS. Parkinson's disease is characterized by the loss of dopamine-producing neurons, Alzheimer's disease by the formation of plaques and tangles in the brain, and Huntington's disease by a genetic mutation affecting nerve cells.

2. The PN and UAP enter a client's room and find the client lying on the bed. The PN determines that the client is unresponsive. Which instruction should the PN give the UAP first?

• A. Obtain emergency help
• B. Feel for a carotid pulse
• C. Bring a glucometer to the room
• D. Check the blood pressure

Correct answer: A

Rationale: The correct answer is to instruct the UAP to obtain emergency help first. When a client is unresponsive, it could indicate a life-threatening condition that requires immediate intervention. Ensuring emergency help is on the way is the priority to address the potentially critical situation. Feeling for a carotid pulse, bringing a glucometer, or checking the blood pressure are important assessments but should come after taking steps to secure immediate assistance.

3. In a group therapy setting, one member is very demanding, repeatedly interrupting others and taking most of the group time. The nurse's best response would be:

• A. Will you briefly summarize your point because others need time as well?
• B. Your behavior is obnoxious and drains the group.
• C. I am so frustrated with your behavior.
• D. To ignore the behavior and allow him to vent

Correct answer: A

Rationale: In a group therapy setting, where each member should have the opportunity to participate, it is essential for the nurse to manage disruptive behavior assertively yet respectfully. Choice A is the best response as it addresses the issue of one member dominating the group time by asking them to summarize their point briefly, allowing others to contribute. Choice B is confrontational and may alienate the individual, hindering the therapeutic process. Choice C expresses personal frustration, which is not constructive in managing the situation. Choice D of ignoring the behavior is not effective as it allows the disruptive behavior to continue, impacting the group dynamics negatively.

4. What is the most effective way to communicate with a patient who has expressive aphasia?

• A. Asking yes or no questions
• B. Encouraging the patient to write responses
• C. Using picture boards or communication cards
• D. Speaking slowly and clearly

Correct answer: C

Rationale: The most effective way to communicate with a patient who has expressive aphasia is by using picture boards or communication cards. These tools allow patients to convey their needs and responses more effectively when they struggle to speak. Using picture boards or communication cards (Choice C) is preferred as it provides a visual aid to support communication. Asking yes or no questions (Choice A) may limit the patient's ability to express themselves fully. Encouraging the patient to write responses (Choice B) may not be suitable if the patient also has difficulty writing due to the aphasia. While speaking slowly and clearly (Choice D) is important, it may not be sufficient to overcome the communication challenges faced by patients with expressive aphasia.

5. What is the most appropriate nursing action when a patient on anticoagulant therapy develops sudden, severe back pain?

• A. Administer pain medication
• B. Apply a cold compress to the back
• C. Assess for signs of internal bleeding
• D. Reposition the patient for comfort

Correct answer: C

Rationale: When a patient on anticoagulant therapy experiences sudden, severe back pain, the priority nursing action is to assess for signs of internal bleeding. Severe back pain in this context could be indicative of internal bleeding, such as a retroperitoneal bleed, which is a critical condition requiring immediate attention. Administering pain medication or applying a cold compress may mask or delay the identification of a potentially life-threatening situation. Repositioning the patient for comfort is not the priority when internal bleeding needs to be ruled out.

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