Nursing Elites

1. Which laboratory value reported to the nurse by the unlicensed assistive personnel (UAP) indicates the most urgent need for the nurse�s assessment of the patient?

• A. Bedtime glucose of 140 mg/dL
• B. Noon blood glucose of 52 mg/dL
• C. Fasting blood glucose of 130 mg/dL
• D. 2-hr postprandial glucose of 220 mg/dL

Correct answer: B

Rationale:

2. A diabetic patient who has reported burning foot pain at night receives a new prescription. Which information should the nurse teach the patient about amitriptyline (Elavil)?

• A. Amitriptyline decreases the depression caused by your foot pain.
• B. Amitriptyline helps prevent transmission of pain impulses to the brain.
• C. Amitriptyline corrects some of the blood vessel changes that cause pain.
• D. Amitriptyline improves sleep and reduces awareness of nighttime pain.

Correct answer: B

Rationale: The correct answer is B. Amitriptyline is a tricyclic antidepressant that works by inhibiting the reuptake of serotonin and norepinephrine, which helps in reducing the transmission of pain impulses to the brain. Choice A is incorrect because amitriptyline primarily works on pain transmission rather than directly on depression. Choice C is inaccurate as amitriptyline's mechanism of action is not related to correcting blood vessel changes. Choice D is partially true as amitriptyline can improve sleep, but the primary mechanism related to pain relief is by preventing pain impulses from reaching the brain.

3. Which of the following should be included in a discussion of advance directives with new nurse graduates?

• A. According to the Patient Self-Determination Act, nurses are required to inform clients of their right to create an advance directive.
• B. The advance directive designates an individual who will make financial decisions for the client if he or she is unable to do so.
• C. A living will designates who will make health-care decisions for an individual in the event the individual is unable or incompetent to make his or her own decisions.
• D. The advance directive designates a health-care surrogate who will make known the client�s wishes regarding medical treatment if the client is unable to do so.

Correct answer: A

Rationale: According to the Patient Self-Determination Act, nurses are required to inform clients of their right to create an advance directive.

4. A nurse has a seriously ill parent and must take care of the parent at home. Which of the following would NOT be a suitable solution to this problem? (EXCEPT)

• A. Resignation
• B. FMLA
• C. Termination
• D. LOA

Correct answer: C

Rationale: FMLA (Family and Medical Leave Act) provides up to 12 weeks of unpaid, job-protected leave to care for a seriously ill family member, securing the employee's job status. Termination and resignation involve ending employment, which is not a suitable solution as it does not provide job security. LOA (Leave of Absence) is often unpaid and does not guarantee job protection, making it less suitable than FMLA in this scenario.

5. A nurse is completing an admission assessment for a client who reports vomiting and diarrhea for the past 3 days. Which of the following findings should the nurse expect?

• A. Blood pressure 144/82 mm Hg
• B. Urine specific gravity 1.03
• C. Neck vein distention
• D. Urine specific gravity 1.01

Correct answer: A

Rationale: In a client experiencing vomiting and diarrhea, the nurse should expect findings such as dehydration, which can lead to hypovolemia and subsequent increased heart rate and decreased blood pressure. A blood pressure of 144/82 mm Hg is indicative of possible dehydration in this client. Urine specific gravity is typically increased in dehydrated individuals, so choices B and D are incorrect. Neck vein distention is not a typical finding associated with vomiting and diarrhea; therefore, choice C is also incorrect.

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