Nursing Elites

1. While assessing an older male client who takes psychotropic medications, the nurse observes uncontrollable hand movements and excessive blinking. Which information in the client's medical record should the nurse review?

• A. Prescription for lorazepam
• B. History of Parkinson's disease
• C. Screening for tardive dyskinesia
• D. Recent urine drug screen report

Correct answer: C

Rationale: The symptoms of uncontrollable hand movements and excessive blinking are indicative of tardive dyskinesia, a possible side effect of long-term use of psychotropic medications. Reviewing the screening for tardive dyskinesia is crucial to assess if these symptoms are related to the medication. Option A, the prescription for lorazepam, is less relevant as the focus should be on potential side effects rather than the specific medication. Option B, history of Parkinson's disease, is not directly related to the observed symptoms, which are more likely linked to medication side effects. Option D, recent urine drug screen report, is not as pertinent in this context compared to reviewing the screening for tardive dyskinesia.

2. A client post-lobectomy is placed on mechanical ventilation. The nurse notices the client is fighting the ventilator. What should the nurse do first?

• A. Increase the sedation as prescribed.
• B. Manually ventilate the client using an ambu bag.
• C. Check the ventilator settings and alarms.
• D. Suction the client’s airway.

Correct answer: C

Rationale: The correct first action for the nurse to take when a client is fighting the ventilator is to check the ventilator settings and alarms. This step is crucial to ensure that the ventilator is functioning correctly and providing the necessary support to the client. Increasing sedation (Choice A) should only be considered after confirming that the ventilator settings are appropriate. While manually ventilating the client (Choice B) may be required in some cases, it is not the initial action to take. Suctioning the client's airway (Choice D) is not the priority in this situation, where the primary concern is addressing the client's struggle with the ventilator.

3. A male client attends a community support program for mentally impaired and chemically abusing clients. The client tells the PN that his drugs of choice are cocaine and heroin. What is the greatest health risk for this client?

• A. Hypertension
• B. Hepatitis
• C. Glaucoma
• D. Diabetes

Correct answer: B

Rationale: The correct answer is B: Hepatitis. Hepatitis is the greatest health risk for this client due to the potential for contracting the disease through needle-sharing, common among drug users. This can lead to serious liver complications. While hypertension, glaucoma, and diabetes are all important health concerns, they are not directly associated with the drug abuse mentioned in the scenario.

4. What is the first action a healthcare professional should take when a patient’s nasogastric (NG) tube becomes clogged?

• A. Flush the tube with water
• B. Reposition the patient
• C. Attempt to aspirate the clog with a syringe
• D. Administer a medication to dissolve the clog

Correct answer: C

Rationale: When a patient's nasogastric (NG) tube becomes clogged, the first action to take is to attempt to aspirate the clog with a syringe. This is a standard and initial step to clear the blockage in the tube. Flushing the tube with water (Choice A) may not address the specific clog; repositioning the patient (Choice B) is not directly related to clearing the tube. Administering a medication to dissolve the clog (Choice D) should only be considered after simpler methods like aspiration have been attempted.

5. The practical nurse is caring for a client whose urine drug screen is positive for cocaine. Which behavior is this client likely to exhibit during cocaine withdrawal?

• A. Elevated energy level
• B. Euphoria
• C. High self-esteem
• D. Powerful craving for more

Correct answer: D

Rationale: The correct answer is D: Powerful craving for more. During cocaine withdrawal, individuals often experience intense cravings for the drug, along with symptoms such as fatigue, depression, and anxiety. These cravings can be overpowering and lead to a strong desire to seek out more cocaine to alleviate the withdrawal symptoms. Choices A, B, and C are incorrect as elevated energy level, euphoria, and high self-esteem are more associated with the effects of cocaine rather than withdrawal symptoms. Withdrawal from cocaine is characterized by the opposite, such as fatigue, low mood, and intense cravings.

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