Nursing Elites

1. Which of the following goals is the most important for the nurse to address for a client admitted to the cardiac rehabilitation unit?

• A. Reduction of anxiety
• B. Referral to community resources
• C. Identification of lifestyle changes
• D. Verbalization of energy-conservation techniques

Correct answer: C

Rationale: The most important goal for a client admitted to the cardiac rehabilitation unit is the identification of lifestyle changes. This is crucial in promoting cardiovascular health and preventing future cardiac issues. Lifestyle changes such as diet modifications, exercise routines, smoking cessation, and stress management play a significant role in improving the overall cardiovascular well-being of the patient. While reducing anxiety, referring to community resources, and verbalizing energy-conservation techniques are all important aspects of care, identifying lifestyle changes is the primary focus in helping the client achieve long-term cardiovascular wellness.

2. One week ago, a client was involved in a motor vehicle crash (MVC) and was brought to the Emergency Department (ED). In the emergency department, the client received two stitches to the forehead and was sent home. Today, the client's spouse notes that the client 'acts like he is drunk' and cannot control his right foot and arm. The nurse will suspect?

• A. Meningitis
• B. Absence seizure
• C. Subdural hematoma
• D. Meniere's disease

Correct answer: C

Rationale: Yes! The nurse will suspect a subdural hematoma. In this case, the client's presentation of acting intoxicated and experiencing loss of motor control in the right foot and arm is indicative of an acute subdural hematoma. This condition can occur after a head injury with a slow venous bleed, where symptoms may not show until compensation mechanisms are overwhelmed. Meningitis (choice A) usually presents with fever, headache, and neck stiffness. Absence seizure (choice B) is characterized by brief periods of unconsciousness without convulsions. Meniere's disease (choice D) manifests with symptoms like vertigo, hearing loss, and tinnitus, which do not match the client's current symptoms.

3. A 20-year-old obese female client is preparing to have gastric bypass surgery for weight loss. She says to the nurse, "I need this surgery because nothing else I have done has helped me to lose weight."? Which response by the nurse is most appropriate?

• A. "If you eat less, you can save some money."?
• B. "Exercise is a healthier way to lose weight."?
• C. "You should try the Atkins diet first."?
• D. "I respect your decision to choose surgery."?

Correct answer: D

Rationale: The most appropriate response by the nurse is to show respect and empathy towards the client's decision. Option D acknowledges the client's autonomy and decision-making process, fostering a therapeutic relationship. Options A, B, and C are insensitive and unprofessional. Option A implies a financial incentive for weight loss, which can be perceived as disrespectful and trivializing the client's concerns. Option B suggests an alternative method without considering the client's reasons for choosing surgery, potentially invalidating her experiences. Option C recommends a specific diet without addressing the client's concerns or choices, neglecting her autonomy in decision-making.

4. Chemotherapeutic agents often produce a degree of myelosuppression including leukopenia. Leukopenia does not present immediately but is delayed several days or weeks because:

• A. the client's hemoglobin and hematocrit are normal.
• B. red blood cells are affected first.
• C. folic acid levels are normal.
• D. the current white cell count is not affected by chemotherapy.

Correct answer: D

Rationale: Leukopenia does not present immediately after chemotherapy because time is required to clear circulating cells before the effect on precursor cell maturation in the bone marrow becomes evident. Leukopenia is characterized by an abnormally low white blood cell count. The correct answer is D because the white cell count is not immediately affected by chemotherapy. Choices A, B, and C are incorrect as they pertain to red blood cells (hemoglobin and hematocrit), which are not directly related to the delayed onset of leukopenia.

5. Which client should be seen first by the Emergency Department nurse?

• A. A six-year-old with a femur fracture.
• B. A two-year-old with a fever of 102 degrees F.
• C. A three-year-old with wheezes in the right lower lobe.
• D. A two-year-old whose gastrostomy tube came out.

Correct answer: C

Rationale: The priority in the emergency department is to assess and manage clients based on the severity of their condition. In this scenario, the three-year-old with wheezes in the right lower lobe should be seen first because respiratory distress takes precedence over other conditions. Wheezing indicates potential airway compromise, which requires immediate attention to ensure adequate oxygenation. The other options are important but do not pose an immediate threat to the client's airway and breathing. A femur fracture, fever, or a dislodged gastrostomy tube can be addressed after ensuring the child with respiratory distress is stable.

Similar Questions