Nursing Elites

1. Which of the following medications might cause upper-gastrointestinal (UGI) bleeding?

• A. Cardizem (diltiazem)
• B. Naprosyn (naproxen)
• C. Elavil (amitriptyline)
• D. Corgard (nadolol)

Correct answer: C

Rationale: Naprosyn (naproxen) is known to cause upper-gastrointestinal (UGI) bleeding due to its effects on the stomach lining. Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that can irritate the stomach and increase the risk of UGI bleeding. On the other hand, Cardizem (diltiazem), Elavil (amitriptyline), and Corgard (nadolol) are not typically associated with UGI bleeding. Cardizem is a calcium channel blocker used for hypertension and angina, Elavil is a tricyclic antidepressant, and Corgard is a beta-blocker used for hypertension.

2. Which of the following statements by a client indicates adequate understanding of preparation for a lipoprotein fractionation test?

• A. "I cannot eat or drink after midnight."?
• B. "I cannot eat for 12 hours before the test."?
• C. "I need to limit my fluid intake."?
• D. "I need to ingest a lipid solution."?

Correct answer: B

Rationale: The correct statement regarding preparation for a lipoprotein fractionation test is that the client cannot eat for 12 hours before the test. It is important to note that the client can drink an unrestricted amount of water. Limiting fluid intake is not necessary for this test. There is no need for the client to ingest a lipid solution as part of the preparation. Therefore, the other choices are incorrect.

3. The client with a diagnosis of hepatitis is experiencing pruritus. Which would be the most appropriate nursing intervention?

• A. Suggest that the client take warm showers once a day.
• B. Add baby oil to the client's bath water.
• C. Apply powder to the client's skin.
• D. Suggest a cool-water rinse after bathing.

Correct answer: B

Rationale: Pruritus, or itching, in clients with hepatitis can be alleviated by adding moisturizing agents to bath water. Baby oil helps soothe and moisturize the skin, reducing dryness and itching. Warm showers, as in choice A, can be drying to the skin if taken too frequently, making it less suitable than adding oil to the bath water. Applying powder, as mentioned in choice C, can exacerbate dryness rather than alleviate it. Choice D suggests a cool-water rinse after bathing, which can help in retaining moisture and is less drying compared to hot water rinses.

4. Which of the following isoenzymes is elevated in a client who has had a myocardial infarction?

• A. CPK-BB
• B. CPK-MM
• C. CPK-MB
• D. CPK-MI

Correct answer: C

Rationale: CPK-MB is the correct answer as it is elevated in clients who have had a myocardial infarction. CPK-BB is elevated in clients with brain damage, and CPK-MM is elevated in clients with skeletal muscle damage. CPK-MI, mentioned in the rationale, does not exist, making it an incorrect choice.

5. Which of the following clients would be most appropriate for an LPN to assign to a nursing assistant?

• A. an 18-year-old client with a femur fracture who is just returning to the floor from the recovery unit
• B. an 84-year-old client 2 days post-op after knee replacement surgery who needs help ambulating
• C. a 35-year-old client who is suffering from an acute asthma attack
• D. a 20-year-old client with Cystic Fibrosis who needs an early morning sputum sample collection

Correct answer: D

Rationale: Collecting sputum samples on stable clients is within the scope of practice for an LPN. This task does not require immediate intervention or assessment by an RN or medical provider. An RN should perform the initial assessment on any client immediately post-op as it requires a higher level of assessment and monitoring. A client suffering from an acute asthma attack should be attended to by an RN or medical provider due to the potential severity and need for prompt intervention. Assigning a medically stable client who needs help ambulating to a nursing assistant is appropriate as it falls within their scope of practice and allows the LPN to focus on tasks that require their expertise.

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