Nursing Elites

1. Which of the following patients is at greatest risk for developing pressure ulcers?

• A. An alert chronic arthritic patient treated with steroids and aspirin
• B. An 88-year-old incontinent patient with gastric cancer who is confined to bed at home
• C. An apathetic 63-year-old COPD patient receiving nasal oxygen via cannula
• D. A confused 78-year-old patient with congestive heart failure (CHF) who requires assistance to get out of bed

Correct answer: B

Rationale: The correct answer is B. An elderly patient who is incontinent, bedridden, and suffering from a serious illness like gastric cancer is at the highest risk for developing pressure ulcers. Being bedridden and incontinent increases the pressure on certain areas of the body, leading to tissue damage and the development of pressure ulcers. Additionally, the patient's age and underlying health condition further contribute to their risk. It is crucial to identify and address such risk factors promptly to prevent the occurrence of pressure ulcers in vulnerable patients.

2. A client with heart failure has a new prescription for furosemide. Which of the following statements should the nurse make?

• A. Taking furosemide can cause your potassium levels to be high
• B. Eat foods that are high in sodium
• C. Rise slowly when getting out of bed
• D. Taking furosemide can cause you to be overhydrated

Correct answer: C

Rationale: Educating the client on the importance of rising slowly when getting out of bed is crucial due to the risk of orthostatic hypotension associated with furosemide use. This precaution helps prevent dizziness and falls. Options A and D are incorrect as furosemide commonly causes hypokalemia and dehydration, respectively, rather than high potassium levels or overhydration. Option B is inaccurate as clients on furosemide need to reduce sodium intake to manage fluid retention.

3. Which of the following scenarios represents nursing malpractice?

• A. The nurse administers penicillin to a patient with a documented history of allergy to the drug. The patient experiences an allergic reaction and suffers cerebral damage due to anoxia.
• B. The nurse applies a hot water bottle or a heating pad to the abdomen of a patient with abdominal cramping.
• C. The nurse assists a patient out of bed with the bed locked in position; the patient slips and fractures his right humerus.
• D. The nurse administers the wrong medication to a patient, resulting in vomiting. This error is documented and reported to the physician and the nursing supervisor.

Correct answer: A

Rationale: The correct answer is A. Administering a drug to a patient with a known allergy, leading to severe harm such as an allergic reaction causing cerebral damage due to anoxia, constitutes nursing malpractice. In this scenario, the nurse failed to adhere to the standard of care by administering a medication that the patient was allergic to, resulting in serious harm, which is a clear example of malpractice in nursing.

4. Which deficiency is most commonly seen in individuals with alcohol use disorder?

• A. Thiamine
• B. Riboflavin
• C. Pyridoxine
• D. Pantothenic acid

Correct answer: A

Rationale: Thiamine deficiency, also known as Vitamin B1 deficiency, is the most common vitamin deficiency seen in individuals with alcohol use disorder. Chronic alcohol consumption can lead to decreased thiamine absorption and utilization, as well as poor dietary intake. Thiamine deficiency can result in serious neurological complications, such as Wernicke-Korsakoff syndrome, making it essential to address thiamine supplementation in individuals with alcohol use disorder.

5. A healthcare professional is reviewing the laboratory results of a client who has rheumatoid arthritis. Which of the following findings should the healthcare professional report to the provider?

• A. WBC count 8,000/mm�
• B. Platelets 150,000/mm�
• C. Aspartate aminotransferase 10 units/L
• D. Erythrocyte sedimentation rate 75 mm/hr

Correct answer: D

Rationale: In clients with rheumatoid arthritis, an elevated erythrocyte sedimentation rate (ESR) is a common finding and indicates inflammation in the body. A high ESR value suggests active disease activity and potential joint damage. Therefore, the healthcare professional should report an ESR of 75 mm/hr to the provider for further evaluation and management of the client's rheumatoid arthritis.

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