Nursing Elites

1. You are teaching a client about the patient-controlled analgesia (PCA) planned for post-operative care. Which statement indicates further teaching may be needed by the client?

• A. ''I will be receiving continuous doses of medication.''
• B. ''I should call the nurse before I take additional doses.''
• C. ''I will call for assistance if my pain is not relieved.''
• D. ''The machine will prevent an overdose.''

Correct answer: B

Rationale: PCA allows patients to self-administer pain medication within prescribed limits, without the need to call the nurse before taking an additional dose. Choice B suggests a misunderstanding of how PCA works, as the patient should be educated that they can self-administer doses within the safety parameters set by the healthcare provider. Choices A, C, and D demonstrate proper understanding of PCA, hence are not indicative of needing further teaching.

2. A client with tuberculosis is receiving isoniazid (INH). The nurse should monitor the client for which of the following side effects?

• A. Hepatotoxicity
• B. Hyperglycemia
• C. Hypotension
• D. Hypokalemia

Correct answer: A

Rationale: The correct answer is A: Hepatotoxicity. Isoniazid (INH) can lead to hepatotoxicity, necessitating the monitoring of liver function tests. This adverse effect is characterized by liver damage and dysfunction. Choices B, C, and D are incorrect because isoniazid is not typically associated with hyperglycemia, hypotension, or hypokalemia. Therefore, the nurse should focus on assessing for signs and symptoms of hepatotoxicity in a client receiving isoniazid.

3. While discussing the science of nursing, the nurse identifies the domain of nursing theory. Which linkages should the nurse provide to describe nursing's paradigm?

• A. The person, the environment or situation, and health.
• B. Stress reduction, self-care, and a systems model.
• C. Curative care, restorative care, and terminal care.
• D. Self-actualization, fundamental needs, and belonging.

Correct answer: A

Rationale: The correct answer is A: 'The person, the environment or situation, and health.' In nursing theory, the paradigm includes these core components: the person receiving care, the environment or situation influencing care, and the goal of achieving optimal health outcomes. Choices B, C, and D are incorrect as they do not align with the fundamental aspects of nursing theory and its paradigm.

4. The nurse is caring for a 4-year-old child with a greenstick fracture. In explaining this type of fracture to the parents, the best response by the nurse should be that

• A. A child's bone is more flexible and can be bent 45 degrees before breaking
• B. Bones of children are more porous than adults and often have incomplete breaks
• C. Compression of porous bones produces a buckle or torus type break
• D. Bone fragments often remain attached by a periosteal hinge

Correct answer: B

Rationale: The correct answer is B. Greenstick fractures are common in children because their bones are softer and more porous than adult bones, leading to incomplete breaks when force is applied. Choice A is incorrect as greenstick fractures are not due to bone flexibility but rather the porous nature of children's bones. Choice C is incorrect as it describes a buckle or torus type break, which is not characteristic of a greenstick fracture. Choice D is incorrect as greenstick fractures do not involve bone fragments remaining attached by a periosteal hinge.

5. After accepting the position of school nurse in a public elementary school, what strategy is best for the nurse to use to obtain an overview understanding of the student body?

• A. Review all health records of the students currently enrolled in classes.
• B. Talk with the current members of the parent-teacher association.
• C. Send a survey form to parents of third-grade students.
• D. Conduct a windshield survey of the geographic areas served by the school.

Correct answer: D

Rationale: Conducting a windshield survey is the best strategy for the nurse to obtain an overview understanding of the student body. This method allows the nurse to observe the community, its resources, potential health hazards, and demographic information. Reviewing health records (Choice A) would provide detailed health information but not an overview of the student body. Talking with the parent-teacher association (Choice B) may offer insights but not a comprehensive overview. Sending a survey form to parents (Choice C) may provide specific information but may not capture a broad understanding of the student body.

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