Nursing Elites

1. Why is it often necessary to draw a complete blood count and differential (CBC/differential) when a client is being treated with an antiepileptic drug (AED)?

• A. The hematocrit is adversely affected due to increased vascular volume.
• B. AEDs can lead to blood dyscrasia as a side effect.
• C. AEDs may cause aplastic anemia and megaloblastic anemia.
• D. Some AEDs induce white blood cell reduction.

Correct answer: B

Rationale: When a client is being treated with antiepileptic drugs (AEDs), it is essential to monitor for potential side effects on blood parameters. Some AEDs can lead to blood dyscrasia, which includes conditions like aplastic anemia and megaloblastic anemia. Therefore, drawing a complete blood count and differential helps in identifying these adverse effects early. Choices A, C, and D are incorrect because the primary concern when monitoring blood parameters in clients on AEDs is the risk of blood dyscrasia, not changes in hematocrit due to vascular volume, white blood cell reduction, or immune modulation.

2. The nurse is obtaining a health assessment from the preoperative client scheduled for hip replacement surgery. Which statement by the client would be most important for the nurse to report to the physician?

• A. "I had chickenpox when I was 8 years old."?
• B. "I had rheumatic fever when I was 10 years old."?
• C. "I have a strong family history of gastric cancer."?
• D. "I have pain in my hip with any movement."?

Correct answer: B

Rationale: The most important statement for the nurse to report to the physician is that the client had rheumatic fever when they were 10 years old. This information is crucial as individuals who have had rheumatic fever require pre-medication with antibiotics before any surgical or dental procedure to prevent bacterial endocarditis. Reporting this history ensures the client's safety during the hip replacement surgery. The other options, such as having chickenpox in the past, a family history of gastric cancer, or experiencing hip pain, are important for the client's overall health assessment but do not have the same immediate implications for the upcoming surgery as the history of rheumatic fever.

3. The nurse is caring for a client with decreased cardiac output secondary to heart failure with fluid volume overload. The effects of diminished renal perfusion will have which physiologic response?

• A. Diuresis
• B. Increased fluid retention
• C. Elevated bicarbonate level
• D. Paroxysmal idiopathic narcosis

Correct answer: B

Rationale: When there is diminished renal perfusion due to decreased cardiac output, the kidneys receive less blood flow. This leads to a decrease in urine output and an increase in fluid retention, as the kidneys are not able to effectively filter and excrete excess fluid. Elevated bicarbonate level and paroxysmal idiopathic narcosis are not typically associated with diminished renal perfusion in heart failure. Therefore, the correct answer is 'Increased fluid retention.'

4. What vitamin is important in preventing peripheral neuritis in a client with alcohol abuse?

• A. Vitamin D
• B. Fat-soluble vitamins
• C. B vitamins
• D. Potassium

Correct answer: B

Rationale: The correct answer is 'Fat-soluble vitamins.' Vitamin B, not Vitamin D, is crucial in preventing peripheral neuritis in individuals with alcohol abuse. Vitamin B deficiency, particularly B1 (thiamine), is commonly associated with peripheral neuritis in alcoholics. Therefore, choices A, C, and D are incorrect. Vitamin D is not directly related to peripheral neuritis, and potassium deficiency typically presents with different symptoms.

5. The nurse is caring for a preschool child who is being treated in the hospital for respiratory syncytial virus (RSV). In planning the client's care, the nurse should recognize that the child is likely to view this illness as?

• A. Punishment.
• B. Disturbance to body image.
• C. Rejection from parents.
• D. Change in routine with friends.

Correct answer: A

Rationale: The correct answer is A: Punishment. Preschool children often see illness as a form of punishment, especially when they are unable to understand the cause of their sickness. This perception is rooted in their limited cognitive abilities and understanding of health concepts. Choices B, C, and D are incorrect because preschool children are less likely to associate illness with disturbance to body image, rejection from parents, or changes in routine with friends. These options are not developmentally appropriate for how preschoolers typically interpret illness.

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