Nursing Elites

1. A client with chronic renal failure is receiving erythropoietin (Epogen). The nurse should monitor the client for which of the following side effects?

• A. Hypertension
• B. Hypoglycemia
• C. Hyperkalemia
• D. Hypocalcemia

Correct answer: A

Rationale: The correct answer is A: Hypertension. Erythropoietin can lead to hypertension as a side effect due to its stimulation of red blood cell production, which can increase blood viscosity. This can result in elevated blood pressure. Choices B, C, and D are incorrect. Hypoglycemia is not a common side effect of erythropoietin. Hyperkalemia is more commonly associated with renal failure rather than erythropoietin use. Hypocalcemia is not a typical side effect of erythropoietin administration.

2. An infant has just returned from surgery for placement of a gastrostomy tube as an initial treatment for tracheoesophageal fistula. The mother asks, 'When can the tube be used for feeding?' The nurse's best response would be which of these comments?

• A. "Feedings can begin in 5 to 7 days."
• B. "The use of the feeding tube can begin immediately."
• C. "The stomach contents and air must be drained first."
• D. "The incision healing must be complete before feeding."

Correct answer: C

Rationale: The correct answer is C: 'The stomach contents and air must be drained first.' Before starting feedings through a gastrostomy tube, it is essential to drain the stomach contents and air. This process helps prevent complications and ensures the proper functioning of the tube after placement. Choice A is incorrect because initiating feedings within 5 to 7 days may lead to complications if the stomach is not adequately prepared. Choice B is incorrect as feeding should not begin immediately to allow for proper preparation of the tube and the stomach. Choice D is incorrect because although incision healing is important, draining the stomach contents and air is a more immediate concern to prevent complications.

3. Prior to initiating a community health program targeting teenage smoking, what information is most important for the nurse to obtain?

• A. The incidence of smoking among the teenage population in this community.
• B. The amount of available funding for tobacco prevention education programs.
• C. The target objectives for teenage smoking described by Healthy People 2020.
• D. Satisfaction data from programs that targeted the teenage population in this community.

Correct answer: A

Rationale: The most important information for the nurse to obtain before initiating a community health program targeting teenage smoking is the incidence of smoking among the teenage population in the community. Understanding the prevalence of smoking will help in designing effective intervention strategies. Choice B about funding, while important, is secondary to understanding the scope of the issue. Choice C, the target objectives from Healthy People 2020, may provide guidance but are not as crucial as knowing the local prevalence. Choice D, satisfaction data from previous programs, does not provide essential information for planning a new program.

4. The nurse understands that the primary goal of the occupational health program is:

• A. curative care of workers/employees
• B. birth and death rates
• C. disease trends
• D. social environmental conditions

Correct answer: A

Rationale: The primary goal of an occupational health program is to provide curative care to workers/employees. This includes preventing and treating work-related illnesses and injuries, promoting workplace safety, and ensuring the well-being of employees in their work environment. Choice B, birth and death rates, is not directly related to the primary goal of an occupational health program. Choice C, disease trends, may be a focus of public health programs but is not the primary goal of an occupational health program. Choice D, social environmental conditions, while important for overall health, is not the primary goal of an occupational health program which is more focused on the health and safety of workers in their work settings.

5. Which playroom activities should the nurse organize for a small group of 7-year-old hospitalized children?

• A. Sports and games with rules
• B. Finger paints and water play
• C. "Dress-up" clothes and props
• D. Chess and television programs

Correct answer: A

Rationale: Sports and games with rules are appropriate for the cognitive development stage of 7-year-olds.

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