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. Select all of the risk factors that are associated with deep vein thrombosis.

• A. The use of oral contraceptives
• B. Type B and O blood
• C. Rh negative blood
• D. Underweight

Correct answer: A

Rationale: The correct answer is A: "The use of oral contraceptives." Risk factors for deep vein thrombosis include factors such as immobility, surgery, cancer, obesity, smoking, and the use of oral contraceptives. Choices B, C, and D are incorrect because blood type and Rh factor do not play a role in the development of deep vein thrombosis, and being underweight is not typically considered a risk factor for this condition.

3. Which statement about appendicitis is accurate and true?

• A. Appendicitis is more common among females than males.
• B. A high fiber diet is a risk factor associated with appendicitis.
• C. Left lower quadrant pain is suggestive of appendicitis.
• D. McBurney's point tenderness is suggestive of appendicitis.

Correct answer: D

Rationale: The correct answer is D: McBurney's point tenderness is suggestive of appendicitis. McBurney's point is located in the right lower abdomen and tenderness at this point is a classic sign of appendicitis. Choice A is incorrect as appendicitis is slightly more common in males than females. Choice B is incorrect as a high fiber diet is actually considered to be protective against appendicitis. Choice C is incorrect as appendicitis typically presents with pain in the right lower quadrant, not the left.

4. Clients with type 1 diabetes may require which of the following changes to their daily routine during periods of infection?

• A. No change
• B. Less insulin
• C. More insulin
• D. Oral antidiabetic agents

Correct answer: C

Rationale: During periods of infection, clients with type 1 diabetes may require more insulin to manage the increased blood glucose levels caused by stress and illness. Insulin needs often rise during infections due to the body's increased resistance to the effects of insulin. Therefore, increasing insulin doses is crucial to maintain blood glucose control. Choices A, B, and D are incorrect. Option A ('No change') is inaccurate because during infections, insulin requirements typically increase. Option B ('Less insulin') is incorrect as the body's increased insulin resistance during infections usually necessitates higher insulin doses. Option D ('Oral antidiabetic agents') is not suitable for type 1 diabetes management as these medications are primarily used for type 2 diabetes.

5. Which of the following nursing interventions should be taken for a client who complains of nausea and vomits one hour after taking his glyburide (DiaBeta)?

• A. Administer glyburide again
• B. Administer subcutaneous insulin and monitor blood glucose
• C. Monitor blood glucose closely, and look for signs of hypoglycemia
• D. Monitor blood glucose and assess for signs of hyperglycemia

Correct answer: C

Rationale: After a client complains of nausea and vomits one hour after taking glyburide, the priority nursing intervention should be to monitor blood glucose closely and look for signs of hypoglycemia. Vomiting could indicate that the glyburide was not properly absorbed, potentially leading to hypoglycemia. Administering glyburide again (Choice A) could worsen hypoglycemia. Administering subcutaneous insulin (Choice B) is not appropriate without assessing the blood glucose first. Monitoring for signs of hyperglycemia (Choice D) is not the immediate concern in this situation.

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