Nursing Elites

1. 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.

2. A nurse enters a client room to witness an informed consent for a gastroscopy. The client states he does not understand the procedure. Which of the following actions should the nurse take?

• A. Educate the client about the risks of refusing medications
• B. Complete an incident report
• C. Answer the client's question concerning the procedure
• D. Inform the provider that the client requires clarification about the procedure

Correct answer: D

Rationale: The correct action for the nurse to take in this situation is to inform the provider that the client requires clarification about the procedure. This ensures that the client fully understands the gastroscopy procedure before giving consent. Choice A is incorrect as the client's issue is not about refusing medications. Choice B is irrelevant as there is no incident to report. Choice C could be misleading as the nurse should not be providing information about the procedure but rather ensuring that the client gets the necessary clarification from the provider.

3. The wound irrigation process cleanses the wound and:

• A. Reduces the potential pain in the wound region or area.
• B. Stops the spread of infection by creating a 'clean' area.
• C. Pushes extravasated blood from a hematoma into nearby healthy tissue.
• D. Allows for the introduction of medications in solution form.

Correct answer: D

Rationale: The correct answer is D because wound irrigation allows for the introduction of medications in solution form to the wound site. Choice A is incorrect because while wound irrigation can help with pain management indirectly by promoting healing, its primary purpose is not to reduce pain directly. Choice B is incorrect as wound irrigation primarily aims to cleanse the wound and remove contaminants rather than creating a 'clean' area to stop infection spread. Choice C is incorrect because wound irrigation does not involve pushing extravasated blood from a hematoma into nearby healthy tissue; its main goal is to cleanse the wound and promote healing.

4. Based on the signs and symptoms of erythema marginatum, Sydenham chorea, epistaxis, abdominal pain, fever, cardiac problems, and skin nodules in your 32-year-old female patient, what disorder would you most likely suspect?

• A. Leukemia
• B. Histoplasmosis
• C. Pneumocystis jiroveci
• D. Rheumatoid arthritis

Correct answer: D

Rationale: The signs and symptoms described point towards rheumatoid arthritis. Erythema marginatum, Sydenham chorea, epistaxis, abdominal pain, fever, cardiac issues, and skin nodules are classic manifestations of rheumatic fever, which is a complication of untreated streptococcal infection. This condition can lead to rheumatoid arthritis over time. Choices A, B, and C are incorrect as they do not align with the provided signs and symptoms, and they are not associated with the clinical presentation described.

5. What is the normal sodium level in the body?

• A. 135 to 145 milliequivalents per liter.
• B. 3 to 5 milliequivalents per liter.
• C. 135 to 145 microequivalents per liter.
• D. 3 to 5 microequivalents per liter.

Correct answer: A

Rationale: The correct answer is A: 135 to 145 milliequivalents per liter. The normal range for sodium levels in the body is expressed in milliequivalents per liter, not microequivalents. Choice B and D provide a significantly lower range which is not within the normal values for sodium. Choice C incorrectly states 'microequivalents' instead of the correct unit 'milliequivalents'. Therefore, A is the correct answer.

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