Nursing Elites

1. A client is taking hydrocodone (Vicodin) for chronic back pain. The client has required an increase in the dose and asks whether this means he is addicted to Vicodin. The nurse should base her reply on the knowledge that:

• A. the client's body has developed tolerance, requiring more drug to produce the same effect
• B. the client is preoccupied with getting the drug and is experiencing loss of control, indicating drug dependence
• C. addiction involves psychological behaviors related to substance use, not just physical dependence
• D. the client is coping with chronic back pain and requires adjustments in the medication regimen

Correct answer: A

Rationale: When a client requires an increased dose of a drug, such as in this case with hydrocodone, it suggests that the body has developed tolerance to the medication. Tolerance means that the client needs more of the drug to achieve the same effect as before. This does not inherently indicate addiction, which involves psychological behaviors related to substance use. Choice B describes drug dependence, where the client is preoccupied with obtaining the drug and experiences loss of control, which is not the same as tolerance. Choice C correctly points out that addiction is more than just physical dependence with withdrawal symptoms and tolerance; it includes psychological factors. Choice D is irrelevant as it discusses adjusting the medication for pain management, not addressing the client's concern about addiction.

2. In performing a psychosocial assessment, the nurse begins by asking questions that encourage the client to describe problematic behaviors and situations. The next step is to elicit the client's

• A. feelings about what has been described.
• B. thoughts about what has been described.
• C. possible solutions to the problem.
• D. intent in sharing the description.

Correct answer: B

Rationale: In performing a psychosocial assessment, the nurse follows a structured approach, starting with encouraging the client to describe problematic behaviors and situations. The next step is to elicit the client's thoughts about what has been described. This step helps gather more assessment data and understand how the client interprets the situation. Asking about feelings, exploring possible solutions, and understanding the client's intent in sharing the description are more complex processes that come later in the assessment. Therefore, the correct next step after describing behaviors and situations is to inquire about the client's thoughts.

3. A client with cancer is admitted to the oncology unit. Stat lab values reveal Hgb 12.6, WBC 6500, K+ 1.9, uric acid 7.0, Na+ 136, and platelets 178,000. The nurse evaluates that the client is experiencing which of the following?

• A. Hypernatremia
• B. Hypokalemia
• C. Myelosuppression
• D. Leukocytosis

Correct answer: B

Rationale: The correct answer is 'Hypokalemia.' The potassium level of 1.9 indicates low potassium levels, a condition known as hypokalemia. The other lab values are within normal ranges: Hgb 12.6, WBC 6500, uric acid 7.0, Na+ 136, and platelets 178,000. Hypernatremia (choice A) refers to high sodium levels, which are not present in this case. Myelosuppression (choice C) is a decrease in bone marrow activity, which is not indicated by the lab values provided. Leukocytosis (choice D) is an increase in white blood cells, which is also not present based on the given values.

4. Which nurse should be assigned to care for the postpartal client with preeclampsia?

• A. The nurse with 2 weeks of experience on the postpartum unit
• B. The nurse with 3 years of experience in labor and delivery
• C. The nurse with 10 years of experience in surgery
• D. The nurse with 1 year of experience in the neonatal intensive care unit

Correct answer: B

Rationale: The nurse with 3 years of experience in labor and delivery (answer B) should be assigned to care for the postpartal client with preeclampsia. This nurse has the most relevant experience and knowledge of possible complications associated with preeclampsia due to their background in labor and delivery. Assigning a nurse with only 2 weeks of experience on the postpartum unit (answer A) would not be suitable for handling the complexities of caring for a client with preeclampsia. Nurses with experience in surgery (answer C) or the neonatal intensive care unit (answer D) lack the specific expertise needed for managing a postpartal client with preeclampsia, making them unsuitable choices for this assignment.

5. A client is given an opiate drug for pain relief following general anesthesia. The client becomes extremely somnolent with respiratory depression. The physician is likely to order the administration of:

• A. naloxone (Narcan)
• B. labetalol (Normodyne)
• C. neostigmine (Prostigmin)
• D. thiothixene (Navane)

Correct answer: A

Rationale: The correct answer is naloxone (Narcan). Naloxone is an opioid antagonist used to reverse opioid-induced respiratory depression and somnolence. In this scenario, the client's extreme somnolence and respiratory depression suggest an opioid overdose, making naloxone the appropriate choice to counteract these effects. Labetalol (Normodyne) is a nonselective beta-blocker used to treat hypertension, not opioid overdose. Neostigmine (Prostigmin) is a cholinesterase inhibitor used to reverse neuromuscular blockade, not opioid-induced respiratory depression. Thiothixene (Navane) is an antipsychotic medication used to treat schizophrenia and is not indicated for opioid overdose.

Similar Questions