Nursing Elites

1. After a client has a tubal ligation in the outpatient surgical clinic, what is the priority for the nurse to determine?

• A. The client's prior experiences with outpatient surgery
• B. The client's medical plan and the extent of coverage for outpatient surgery
• C. The client's plan for transportation and care at home
• D. The client's plan to spend the night at the surgical center

Correct answer: C

Rationale: The priority for the nurse is to ensure the client has a safe way to get home and adequate care after discharge. It is crucial to determine the client's transportation arrangements and availability of care at home to ensure a smooth transition postoperatively. Options A and B, though important, are not immediate priorities compared to the client's safety and well-being after the procedure. Option D is incorrect as spending the night at the surgical center is not typically part of the plan for outpatient surgery.

2. The manic client has just interrupted the group session with the counselor for the 4th time, explaining that she already knows this information on 'dealing with others when you are down' and constantly gets up and goes to the front. What should the nurse do at this time?

• A. Engage the client to walk with you to make another pot of coffee
• B. Ask the client to reflect on their behavior to determine if it is appropriate
• C. Ask the group to tell the client how they feel when she interrupts
• D. Instruct the client to perform jumping jacks and count aloud to get rid of some energy

Correct answer: A

Rationale: In this situation, it is important to redirect the client's energy and focus. Engaging the client in a purposeful activity like making another pot of coffee can help distract them from disruptive behavior and provide an outlet for their excess energy. This choice also helps in maintaining a therapeutic environment by involving the client in a constructive task. Asking the client to reflect on their behavior (Choice B) might not be effective during a manic episode as the client may not be in a state to critically analyze their actions. Asking the group to tell the client how they feel (Choice C) can escalate the situation and may not be appropriate in this context. Instructing the client to perform jumping jacks and count aloud (Choice D) may not address the underlying issue of disruptive behavior and may not be suitable for the current situation.

3. A 22-year-old patient in a mental health lock-down unit under suicide watch appears happy about being discharged. Which of the following is probably happening?

• A. The patient is excited about being around family again.
• B. The patient's suicide plan has probably progressed.
• C. The patient's plans for the future have been clarified.
• D. The patient's mood is improving.

Correct answer: B

Rationale: In this scenario, it is concerning that a patient under suicide watch is happy about being discharged as it may indicate that the patient's suicide plan has advanced. This change in behavior should be taken seriously as it can signal an increased risk of self-harm. Choices A, C, and D are less likely as the patient's happiness about discharge in this context is more indicative of a worsening situation rather than positive outcomes like being around family, clarifying future plans, or improving mood.

4. What is a chemical reaction between drugs before their administration or absorption known as?

• A. a drug incompatibility
• B. a side effect
• C. an adverse event
• D. an allergic response

Correct answer: A

Rationale: A chemical reaction between drugs before their administration or absorption is termed a drug incompatibility. This phenomenon commonly happens when drug solutions are mixed before intravenous administration, but it can also occur with orally administered drugs. Choices B, C, and D are incorrect because side effects, adverse events, and allergic responses occur after the administration and absorption of drugs, not prior to it.

5. A patient has just been prescribed Minipress to control hypertension. The nurse should instruct the patient to be observant of the following:

• A. Dizziness and light-headed sensations
• B. Weight gain
• C. Sensory changes in the lower extremities
• D. Fatigue

Correct answer: A

Rationale: The correct answer is 'Dizziness and light-headed sensations.' Minipress, a medication used to control hypertension, can cause hypotension as a side effect. Dizziness and light-headed sensations are common symptoms of hypotension. Weight gain, sensory changes in the lower extremities, and fatigue are not typically associated with Minipress or hypertension management. Therefore, they are incorrect choices.

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