Nursing Elites

1. Which manifestation should the nurse expect to assess in a patient with fluid volume deficit?

• A. Headache and muscle cramps
• B. Dyspnea and respiratory crackles
• C. Increased pulse rate and blood pressure
• D. Orthostatic hypotension and flat neck veins

Correct answer: D

Rationale: Orthostatic hypotension and flat neck veins are classic manifestations of fluid volume deficit. When the body loses fluid, blood volume decreases, leading to decreased venous return to the heart, resulting in orthostatic hypotension and flat neck veins. Choices A, B, and C are more indicative of other conditions such as dehydration, respiratory issues, or compensatory mechanisms in response to hypovolemia, respectively.

2. How do the public view nurses today?

• A. Nurses are assistants to physicians.
• B. Nurses view the person within the family and community.
• C. Nurses are different from other health-care providers.
• D. Nurses are closely involved in shaping the health care of the future.

Correct answer: A

Rationale: The correct answer is A: 'Nurses are assistants to physicians.' The public image of nurses, as portrayed by the media, often positions them as assistants to physicians. This perception stems from historical depictions and the traditional hierarchy within healthcare settings. Choice B is incorrect because it reflects how nurses perceive their patients, not how the public views nurses. Choice C is incorrect as nurses are part of the broader healthcare team but are not seen as fundamentally different from other healthcare providers by the public. Choice D is incorrect as while nurses play a crucial role in shaping healthcare, the public perception often focuses more on their supportive role in the healthcare system.

3. Select the types of pain that are accurately coupled with an example of it. Select all that are correct.

• A. Radicular pain: Pain shooting down the leg from a herniated disc
• B. Central neuropathic pain: Pain from nerve damage after a stroke
• C. Peripheral neuropathic pain: Pain from diabetic neuropathy in the feet
• D. Chronic pain: Pain lasting for more than 3-6 months

Correct answer: D

Rationale: The correct answer is D because chronic pain is characterized by lasting for a prolonged period, typically more than 3-6 months, and is not necessarily related to acute injuries like a stab wound to the chest. Choices A, B, and C are incorrect because they do not accurately match the type of pain with its corresponding example. Radicular pain is pain that radiates along the nerve path, often from a pinched nerve or herniated disc, not a broken bone. Central neuropathic pain arises from damage to the central nervous system, such as after a stroke, not a leg injury. Peripheral neuropathic pain is caused by damage to the peripheral nerves, such as in diabetic neuropathy, not a fractured leg bone.

4. Dr. Shrunk orders intravenous (IV) insulin for Rita, a client with a blood sugar of 563. Nurse AJ administers insulin lispro (Humalog) intravenously (IV). What does the best evaluation of the nurse reveal? Select one that does not apply.

• A. The nurse could have given the insulin subcutaneously.
• B. The nurse did not have to contact the physician.
• C. The nurse should have used regular insulin (Humulin R).
• D. The nurse used the correct insulin.

Correct answer: C

Rationale: The best evaluation of the nurse reveals that she should have used regular insulin (Humulin R) for IV administration. Regular insulin is the only insulin approved for intravenous administration due to its pharmacokinetic properties. Insulin lispro (Humalog) is not suitable for IV use. Choice A is incorrect because giving insulin intravenously is necessary in this case of high blood sugar. Choice B is incorrect because administering a different insulin without consulting the physician is not appropriate. Choice D is incorrect because the nurse used the incorrect insulin, which could pose risks to the client's health.

5. What is idiopathic thrombocytopenia purpura?

• A. Highly similar to disseminated intravascular coagulation (DIC).
• B. Caused by the overproduction of platelets.
• C. A bleeding disorder that is characterized by too few platelets.
• D. Treated with immune system-boosting medications.

Correct answer: C

Rationale: Idiopathic thrombocytopenic purpura is a bleeding disorder characterized by a low number of platelets in the blood. This condition is not highly similar to disseminated intravascular coagulation (DIC), which involves abnormal clotting throughout the body (coagulation), leading to depletion of platelets. Choice B is incorrect because idiopathic thrombocytopenic purpura is actually characterized by a decrease in platelet count, not an overproduction. While immune system-boosting medications may be used in some cases, the primary treatment for idiopathic thrombocytopenic purpura focuses on increasing platelet counts or managing symptoms.

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