Nursing Elites

1. Which hormone is primarily responsible for the regulation of calcium and phosphate in the blood?

• A. Parathyroid hormone
• B. Insulin
• C. Cortisol
• D. Thyroxine

Correct answer: A

Rationale: Parathyroid hormone is the correct answer. It regulates calcium and phosphate levels in the blood by increasing calcium reabsorption in the kidneys and releasing calcium from bones. Insulin is involved in glucose metabolism, not calcium and phosphate regulation. Cortisol is a stress hormone and is not primarily responsible for regulating calcium and phosphate levels. Thyroxine is a thyroid hormone that primarily regulates metabolism, not calcium and phosphate in the blood.

2. The practical nurse is caring for a client whose urine drug screen is positive for cocaine. Which behavior is this client likely to exhibit during cocaine withdrawal?

• A. Elevated energy level
• B. Euphoria
• C. High self-esteem
• D. Powerful craving for more

Correct answer: D

Rationale: The correct answer is D: Powerful craving for more. During cocaine withdrawal, individuals often experience intense cravings for the drug, along with symptoms such as fatigue, depression, and anxiety. These cravings can be overpowering and lead to a strong desire to seek out more cocaine to alleviate the withdrawal symptoms. Choices A, B, and C are incorrect as elevated energy level, euphoria, and high self-esteem are more associated with the effects of cocaine rather than withdrawal symptoms. Withdrawal from cocaine is characterized by the opposite, such as fatigue, low mood, and intense cravings.

3. Which task could the PN safely delegate to the UAP?

• A. Oral feeding of a two-year-old child after application of a hip spica cast
• B. Assessment of the placement and patency of a NG tube
• C. Participation in staff rounds to record notes regarding client goals
• D. Evaluation of a client's incisional pain following narcotic administration

Correct answer: A

Rationale: The correct answer is A because oral feeding of a child is a task that can be safely delegated to an unlicensed assistive personnel (UAP). This task involves providing basic care and does not require specialized nursing skills. Choices B, C, and D involve assessments, recording client goals, and evaluating pain, respectively, which all require specialized nursing knowledge, judgment, and skills. These tasks are not within the scope of practice for a UAP.

4. A client has a prescription for a transcutaneous electrical nerve stimulator (TENS) unit for pain management during the postoperative period following a lumbar laminectomy. Which information should the PN reinforce about the action of the adjuvant pain modality?

• A. The discharge of electricity will distract the client's focus from the pain.
• B. An infusion of medication into the spinal canal will block pain perception.
• C. Pain perception in the cerebral cortex is dulled by the unit's discharge of an electrical stimulus.
• D. A mild electrical stimulus on the skin surface closes the gates of nerve conduction for severe pain.

Correct answer: D

Rationale: The TENS unit works by providing a mild electrical stimulus to the skin, which helps to 'close the gate' on pain signals, reducing the perception of pain. Choice A is incorrect because distraction is not the primary mechanism of action for TENS. Choice B is incorrect as it describes a different method of pain management involving medication infusion into the spinal canal. Choice C is incorrect as it inaccurately describes the location of pain perception modulation by the TENS unit.

5. When preparing to administer a medication through a nasogastric (NG) tube, what is the first action the nurse should take?

• A. Check the placement of the NG tube
• B. Flush the tube with saline
• C. Position the client in a semi-Fowler's position
• D. Administer the medication slowly

Correct answer: A

Rationale: The correct first action when preparing to administer a medication through a nasogastric (NG) tube is to check the placement of the NG tube. This step is essential to ensure that the tube is correctly positioned in the stomach and not in the lungs, preventing potential complications. Flushing the tube with saline may be required, but it should follow the verification of tube placement. Positioning the client in a semi-Fowler's position is necessary for comfort during the procedure but is not the initial step. Administering the medication can only be done safely after confirming the correct placement of the NG tube.

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