Nursing Elites

1. Which medication might the healthcare provider prescribe if the client expresses discomfort with being in the enclosed space of a CT scanner?

• A. Valium (diazepam)
• B. Clozaril (clozapine)
• C. Catapres (clonidine)
• D. Lasix (furosemide)

Correct answer: A

Rationale: Valium (diazepam) is a sedative that might be prescribed to help a client who feels uncomfortable in the confined space of a CT scanner. Diazepam can help reduce anxiety and promote relaxation, making the scanning process more tolerable. Clozaril (clozapine), Catapres (clonidine), and Lasix (furosemide) are not sedatives and wouldn't be appropriate for alleviating discomfort related to being in an enclosed space. Clozaril is an antipsychotic used to treat schizophrenia, Catapres is a blood pressure medication, and Lasix is a diuretic used to treat fluid retention, so they are not indicated for this situation.

2. The client is unsure about making medical decisions as their disease progresses and wants to appoint someone to make these decisions. Which of the following options would be most appropriate?

• A. a living will
• B. informed consent
• C. a healthcare proxy
• D. non-informed consent

Correct answer: C

Rationale: The correct answer is 'a healthcare proxy.' A healthcare proxy involves the client appointing an individual to make medical decisions on their behalf if they become unable to do so. This option allows the client to choose someone they trust to act in their best interests. Choice A, 'a living will,' is a legal document that outlines a person's wishes regarding medical treatment in case they are unable to communicate their decisions. While it is important, it does not involve appointing someone to make decisions. Choice B, 'informed consent,' is a process where a healthcare provider explains a treatment or procedure, including its risks and benefits, to a patient who can then decide whether to proceed. This is not about appointing someone to make decisions on the patient's behalf. Choice D, 'non-informed consent,' is not a valid concept in healthcare. Informed consent is crucial for respecting a patient's autonomy and decision-making capacity.

3. What intervention should the nurse take for a client who has sustained a hyphema?

• A. Instruct the client to wear eye protectors in the future
• B. Keep the client at bed rest, typically with the head of the bed propped up
• C. Apply atropine eyedrops
• D. Apply an ice pack to the site of injury

Correct answer: B

Rationale: The correct intervention for a client who has sustained a hyphema is to keep them at bed rest, usually with the head of the bed raised. This positioning helps to reduce intraocular pressure and prevent further damage or rebleeding. Instructing the client to wear eye protectors in the future (Choice A) is not the immediate intervention required for a hyphema. Applying atropine eyedrops (Choice C) is not typically indicated for a hyphema. Applying an ice pack to the site of injury (Choice D) is not recommended for a hyphema as it can increase the risk of rebleeding. Therefore, the correct answer is to keep the client at bed rest.

4. A client with a pleural drainage system to suction has gentle bubbling of the water seal. What should the nurse do?

• A. Notify the physician.
• B. Clamp the chest tube.
• C. Replace the system.
• D. Document the finding

Correct answer: D

Rationale: Gentle bubbling is a normal finding for a client with a pleural drainage system to suction, so it simply needs to be documented for monitoring purposes. If the bubbling becomes vigorous, it could indicate a leak, which would then require further investigation by the nurse. Therefore, the correct action at this point is to document the finding. Notifying the physician is not necessary for gentle bubbling as it is expected. Clamping the chest tube or replacing the system is inappropriate and could potentially harm the client as there is no indication for such actions based on the scenario provided.

5. A nurse who recently learned she is pregnant has just received client assignments for the day. Which client assignment should the nurse question as being inappropriate?

• A. A client with metastatic cancer who is receiving a continuous infusion of intravenous morphine sulfate
• B. A client with a solid-sealed cervical radiation implant
• C. A client with diarrhea for whom enteric precautions are in effect
• D. A client for whom contact precautions have been implemented and who requires frequent wound irrigations

Correct answer: B

Rationale: The correct answer is a client with a solid-sealed cervical radiation implant. Brachytherapy involves the implantation of a sealed radiation source within the targeted tumor tissue. A client with such an implant emits radiation as long as it is in place. Pregnant nurses should not care for clients with solid-sealed radiation implants due to the potential radiation exposure risk to the fetus. Clients under enteric precautions due to diarrhea, receiving a continuous infusion of intravenous morphine sulfate for cancer pain, or requiring contact precautions and frequent wound irrigations do not pose a risk to pregnant nurses and are appropriate assignments for them. Therefore, the nurse should question the assignment involving the client with the solid-sealed cervical radiation implant as it poses a risk to the fetus.

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