Nursing Elites

1. Which of the following actions would be of highest priority with regards to the external shunt?

• A. Avoid taking blood pressure or blood sample from the arm with the shunt
• B. Instruct the patient not to exercise the arm with the shunt
• C. Heparinize the shunt daily
• D. Change the dressing of the shunt daily

Correct answer: C

Rationale: Heparinizing the shunt daily (choice C) is the highest priority action as it prevents the formation of blood clots that can occlude the shunt, leading to potential complications such as thrombosis. Avoiding taking blood pressure or blood samples from the arm with the shunt (choice A) is also important, but secondary to heparinizing the shunt. Similarly, instructing the patient not to exercise the arm with the shunt (choice B) can help prevent unnecessary strain on the shunt, but it is not as critical as preventing clot formation. Changing the dressing of the shunt daily (choice D) is a standard nursing care practice to prevent infection, but again, it is not as critical as ensuring the shunt remains patent through daily heparinization.

2. As a Nurse Manager, DMLM enjoys her staff of talented and self motivated individuals. She knew that the leadership style to suit the needs of this kind of people is called:

• A. Autocratic
• B. Participative
• C. Democratic
• D. Laissez Faire

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

3. An adolescent client has bloodshot eyes, a voracious appetite, and dry mouth. Which drug abuse would the nurse most likely suspect?

• A. Marijuana
• B. Amphetamines
• C. Barbiturates
• D. Anxiolytics

Correct answer: A

Rationale: The symptoms described, including bloodshot eyes, a voracious appetite, and dry mouth, are consistent with marijuana use. Bloodshot eyes are a common side effect of marijuana due to its effect on blood vessels in the eyes. Marijuana also often causes an increase in appetite (known as 'the munchies') and can result in dry mouth. Amphetamines typically cause symptoms like increased alertness, energy, and decreased appetite. Barbiturates and anxiolytics would not typically cause bloodshot eyes, a voracious appetite, and dry mouth as described in the scenario. Therefore, the most likely drug abuse the nurse would suspect in this case is marijuana.

4. Sickle cell disease is an example of an inherited mistake in the amino acid sequence.

• A. TRUE
• B. FALSE
• C.
• D.

Correct answer: A

Rationale: The statement is TRUE. Sickle cell disease is caused by a genetic mutation in the hemoglobin gene, leading to an abnormal amino acid sequence. This results in the production of abnormal hemoglobin molecules, causing red blood cells to become sickle-shaped. This inherited condition is a classic example of a genetic error affecting the amino acid sequence, making choice A the correct answer. Choices B, C, and D are incorrect as they do not accurately reflect the nature of sickle cell disease.

5. Before and after the operation, the operating suite is managed by the:

• A. Surgeon C. Nurse Manager
• B. Nurse Supervisor D. Chief Nurse
• C.
• D.

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

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