Nursing Elites

1. While taking care of a client, the nurse thinks that physical therapy in the hospital might be beneficial to their condition. The following is the ideal referral process EXCEPT?

• A. Transport the client to the physical therapy room for treatment after receiving an official referral.
• B. Provide the physical therapist with the client's medical record after the referral.
• C. Contact the client's primary care provider to suggest a physical therapy referral.
• D. Request the client to self-refer to the physical therapist.

Correct answer: D

Rationale: The ideal referral process for a client to receive physical therapy in the hospital starts with the nurse contacting the client's primary care provider to discuss and suggest a physical therapy referral. The primary care provider should provide an official referral, which is crucial for initiating the treatment process. After obtaining the official referral, the nurse should provide the physical therapist with the client's medical record. This step is essential for the therapist to assess the client's condition and customize the treatment plan accordingly. Once the physical therapist is informed and prepared, the nurse can then transport the client to the physical therapy room for treatment. Therefore, the correct sequence is to first contact the primary care provider (Choice C), then provide the medical record (Choice B), and finally transport the client for treatment (Choice A). Choice D, suggesting the client self-refer to the physical therapist, is incorrect as the referral process should involve healthcare professionals to ensure proper assessment and treatment planning.

2. Which of the following NSAIDs is most commonly used for a brief period for acute pain?

• A. Advil
• B. Aleve
• C. Toradol
• D. Bextra

Correct answer: C

Rationale: Toradol is the correct answer because it is an NSAID known for its effectiveness in managing acute pain for short durations. It can be administered via intramuscular (IM), intravenous (IV), or oral (PO) routes. Advil (choice A) and Aleve (choice B) are commonly used for mild to moderate pain but may not be as effective for acute pain requiring immediate relief. Bextra (choice D) was withdrawn from the market due to safety concerns, making it an inappropriate choice for acute pain management.

3. A licensed practical nurse arrives at work at the long-term care center and is immediately faced with several activities that require attention. Which activity will the nurse attend to first?

• A. Task assignments for the day
• B. Stocking the medication closet
• C. A phone message from employee health services
• D. A phone message from a client's wife

Correct answer: A

Rationale: The nurse's priority should be attending to task assignments for the day. This ensures that client care can begin promptly and efficiently. Stocking the medication closet is important but can be done after ensuring task assignments are clear. Phone messages from employee health services and a client's wife, although important, can be addressed after organizing the staff for client care.

4. When administering NSAID adjunctive therapy to an elderly client with cancer, the nurse must monitor:

• A. BUN and creatinine.
• B. creatinine and calcium.
• C. Hgb and Hct.
• D. BUN and CFT.

Correct answer: A

Rationale: When an elderly client with cancer is receiving NSAID therapy, monitoring BUN (blood urea nitrogen) and creatinine levels is crucial. NSAIDs can cause renal toxicity, especially in the elderly. BUN and creatinine levels help assess renal function and detect early signs of renal impairment. Monitoring creatinine alone (Choice B) is not sufficient as BUN provides complementary information about renal function. Monitoring hemoglobin (Hgb) and hematocrit (Hct) (Choice C) is important for assessing anemia but not specific to NSAID therapy in the elderly. CFT (Choice D) is not a standard abbreviation in this context, and monitoring coagulation function is not directly related to NSAID therapy in this scenario.

5. What dietary alterations should a pregnant client with congenital heart disease expect?

• A. reduced calories and reduced fat
• B. caffeine and sodium restrictions
• C. decreased protein and increased complex carbohydrates
• D. fluid restriction and reduced calories

Correct answer: B

Rationale: In a pregnant client with congenital heart disease, caffeine should be restricted as it can increase heart rate, which is already under stress due to pregnancy. Sodium restrictions may be necessary to prevent fluid retention, which can worsen the client's heart condition. Decreasing calories, fat, protein, or fluid may not be appropriate as these can lead to nutrient deficiencies or inadequate energy intake, which is crucial during pregnancy. Therefore, options A, C, and D are not the expected dietary alterations in the client's diet during pregnancy with congenital heart disease.

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