Nursing Elites

1. A nurse is caring for a 60-year-old man who is scheduled to have coronary bypass surgery in the morning. He tells the nurse that he is afraid that he will die and he is scared of the surgery. What is the best reply for this nurse to give him?

• A. There is no reason to be scared. My father had this surgery, and now he’s playing tennis with his friends almost every day.
• B. I would be scared too. It’s a natural thing to feel. Don’t worry. Everything will be alright.
• C. You’re scared?
• D. The doctor has performed hundreds of successful bypass surgeries. I have a lot of faith in him.

Correct answer: C

Rationale: The best reply for the nurse to give the patient is option C: 'You’re scared?' This response reflects empathy and understanding, acknowledging the patient's feelings of fear. By directly addressing the patient's emotions, the nurse encourages further expression of concerns, which is crucial in providing emotional support. Choices A and D may come off as dismissive of the patient's feelings by downplaying his fear or shifting the focus to others' experiences. Choice B, although acknowledging the patient's fear, does not actively engage with the patient's emotions or encourage further discussion.

2. A client has a prescription for a transcutaneous electrical nerve stimulator (TENS) unit for pain management during the postoperative period following a lumbar laminectomy. Which information should the PN reinforce about the action of the adjuvant pain modality?

• A. The discharge of electricity will distract the client's focus from the pain.
• B. An infusion of medication into the spinal canal will block pain perception.
• C. Pain perception in the cerebral cortex is dulled by the unit's discharge of an electrical stimulus.
• D. A mild electrical stimulus on the skin surface closes the gates of nerve conduction for severe pain.

Correct answer: D

Rationale: The TENS unit works by providing a mild electrical stimulus to the skin, which helps to 'close the gate' on pain signals, reducing the perception of pain. Choice A is incorrect because distraction is not the primary mechanism of action for TENS. Choice B is incorrect as it describes a different method of pain management involving medication infusion into the spinal canal. Choice C is incorrect as it inaccurately describes the location of pain perception modulation by the TENS unit.

3. What is the primary function of hemoglobin in red blood cells?

• A. Oxygen transport
• B. Immunity
• C. Blood clotting
• D. Carbon dioxide transport

Correct answer: A

Rationale: The correct answer is A: Oxygen transport. Hemoglobin in red blood cells binds to oxygen in the lungs and carries it to tissues throughout the body, releasing it where needed. This process is essential for cellular respiration and energy production. Choices B, C, and D are incorrect because hemoglobin's primary function is not related to immunity, blood clotting, or carbon dioxide transport. Hemoglobin's main role is to transport oxygen, ensuring adequate oxygen supply to body tissues for metabolic processes.

4. The practical nurse is caring for a client whose urine drug screen is positive for cocaine. Which behavior is this client likely to exhibit during cocaine withdrawal?

• A. Elevated energy level
• B. Euphoria
• C. High self-esteem
• D. Powerful craving for more

Correct answer: D

Rationale: The correct answer is D: Powerful craving for more. During cocaine withdrawal, individuals often experience intense cravings for the drug, along with symptoms such as fatigue, depression, and anxiety. These cravings can be overpowering and lead to a strong desire to seek out more cocaine to alleviate the withdrawal symptoms. Choices A, B, and C are incorrect as elevated energy level, euphoria, and high self-esteem are more associated with the effects of cocaine rather than withdrawal symptoms. Withdrawal from cocaine is characterized by the opposite, such as fatigue, low mood, and intense cravings.

5. A client presents to the office with complaints of swelling in the legs, chills, and shortness of breath. During auscultation of the chest, a heart murmur is heard. The client's blood culture reveals a microorganism in the blood. When a microorganism is found in the blood, this condition is called

• A. Bacteremia
• B. Sepsis
• C. Septicemia
• D. Parasitic infection

Correct answer: A

Rationale: When a microorganism is found in the blood, this condition is called bacteremia, which refers to the presence of bacteria in the bloodstream, as indicated by a positive blood culture. If not appropriately treated, bacteremia can progress to septicemia, also known as sepsis. Sepsis is a severe and life-threatening response to an infection, characterized by systemic inflammation and organ dysfunction. Parasitic infections involve pathogens other than bacteria and are not directly related to the scenario described.

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