Nursing Elites

1. Your 54-year-old male HIV-positive patient has just expired. How should you care for this deceased patient?

• A. Bathe the patient, but it is still necessary to use standard precautions because the patient is deceased.
• B. Place the patient in a negative pressure isolated area of the morgue.
• C. Double shroud the patient to prevent the spread of infection.
• D. Bathe the patient using the same standard precautions you used when he was alive.

Correct answer: D

Rationale: Even after a patient has expired, standard precautions should be maintained to prevent the spread of infection. Bathing the deceased patient should be done using the same standard precautions followed when the patient was alive. This includes using personal protective equipment and following proper infection control procedures. Choices A, B, and C are incorrect because standard precautions must still be adhered to even after the patient has passed away to ensure safety and prevent the transmission of infections.

2. Your long-term care patient has chronic pain and at this point in time, the patient needs increasing dosages to adequately control this pain. What is this patient most likely affected by?

• A. Drug addiction
• B. Drug interactions
• C. Drug side effects
• D. Drug tolerance

Correct answer: D

Rationale: The correct answer is D: Drug tolerance. When a patient needs increasing dosages to achieve the same pain relief, it indicates the development of drug tolerance. This means the body has adapted to the drug, requiring higher doses to produce the same effect. Choice A, drug addiction, is incorrect because drug addiction involves a psychological and physical dependence on the drug, which is not described in the scenario. Choice B, drug interactions, is incorrect as it refers to the effects when multiple drugs interact with each other, not the situation described. Choice C, drug side effects, is also incorrect as it pertains to the unintended effects of a drug, not the need for higher doses to control pain.

3. Select the type of skeletal fracture that is correctly paired with its description.

• A. A complete fracture: The fractured bone penetrates through the skin to the skin surface.
• B. A pathological fracture: A fracture that results from some physical trauma.
• C. A greenstick fracture: This bends but does not fracture the bone.
• D. An avulsion fracture: A fracture that pulls a part of the bone from the tendon or ligament

Correct answer: D

Rationale: The correct answer is D. An avulsion fracture occurs when a part of the bone is pulled away by a tendon or ligament. Choice A is incorrect because it describes an open fracture where the bone penetrates the skin. Choice B is incorrect as a pathological fracture results from an underlying disease weakening the bone, not physical trauma. Choice C is incorrect as a greenstick fracture involves the bone bending but not completely breaking.

4. Wilms' tumor is a form of:

• A. Renal cancer.
• B. Liver cancer.
• C. Basal cell carcinoma.
• D. Brain cancer.

Correct answer: A

Rationale: Wilms' tumor is a type of kidney cancer that primarily affects children. The correct answer is A: Renal cancer. This tumor originates in the kidneys and is most commonly found in children, with the peak incidence around 3-4 years of age. Choice B, Liver cancer, is incorrect as Wilms' tumor specifically involves the kidneys, not the liver. Choice C, Basal cell carcinoma, is a form of skin cancer, not related to Wilms' tumor. Choice D, Brain cancer, is incorrect as Wilms' tumor is not associated with the brain but rather with the kidneys.

5. A client with type 1 DM has a finger stick glucose level of 258mg/dl at bedtime. An order for sliding scale insulin exists. The nurse should:

• A. Call the physician
• B. Encourage the intake of fluids
• C. Administer the insulin as ordered
• D. Give the client ½ cup of orange juice

Correct answer: C

Rationale: In this scenario, the client with type 1 DM has a high glucose level at bedtime. The appropriate action for the nurse is to administer the sliding scale insulin as ordered. This insulin regimen is specifically designed to manage high blood glucose levels. Calling the physician is not necessary as the protocol for sliding scale insulin is already in place. Encouraging fluid intake or providing orange juice is not the correct intervention for addressing high blood glucose levels in this case.

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