Nursing Elites

1. A client is recovering from an acute myocardial infarction. Which of the following interventions should the nurse include in the plan of care?

• A. Draw a troponin level every four hours
• B. Perform an EKG every 12 hours
• C. Plan for oxygen therapy with a rebreather mask
• D. Obtain a cardiac rehabilitation consult

Correct answer: D

Rationale: The correct answer is to obtain a cardiac rehabilitation consult. Cardiac rehabilitation is an essential part of the care plan for a client recovering from a myocardial infarction. It helps in improving recovery, enhancing quality of life, and reducing the risk of future cardiac events. Drawing troponin levels and performing EKGs are important for diagnosing and monitoring myocardial infarctions but are not interventions in the post-MI care plan. Oxygen therapy may be necessary based on the client's condition but is not specific to post-MI care.

2. A nurse is giving discharge instructions to a client who has a new ileostomy. The nurse should recognize that the teaching has been effective when the client states:

• A. I will make sure my medications are enteric-coated
• B. My stoma will drain liquid continuously
• C. I will change my pouch system every two weeks
• D. My stoma size will stay the same after it heals

Correct answer: B

Rationale: The correct answer is B. When a client with an ileostomy states that their stoma will drain liquid continuously, it indicates an understanding of the expected outcome. In an ileostomy, the stoma continuously drains liquid stool as it bypasses the large intestine where water is absorbed. Choices A, C, and D are incorrect because ensuring medications are enteric-coated, changing the pouch system every two weeks, and expecting the stoma size to remain the same after healing are not accurate statements related to an ileostomy.

3. A client has been prescribed raloxiphene. As the nurse, you know that raloxiphene is used to treat:

• A. Migraines
• B. Hypertension
• C. Osteoporosis
• D. Heart disease

Correct answer: C

Rationale: Raloxiphene (Evista) is a selective estrogen receptor modulator (SERM) used primarily to prevent and treat osteoporosis in postmenopausal women. It helps to maintain bone density and reduce the risk of fractures by mimicking the effects of estrogen on bone tissue. It is not indicated for the treatment of migraines, hypertension, or heart disease. Therefore, the correct answer is osteoporosis (Choice C). Choices A, B, and D are incorrect as raloxiphene is not used to treat migraines, hypertension, or heart disease.

4. A healthcare provider is among the first responders to a mass-casualty incident and does not know what type of personal protective equipment (PPE) is needed. Which of the following actions should the healthcare provider take?

• A. Use basic gloves and a mask.
• B. Choose the highest level of protection equipment available.
• C. Use only respiratory protection.
• D. Ask a colleague for advice.

Correct answer: B

Rationale: In situations where the type of hazard is unknown, the healthcare provider should choose the highest level of protection equipment available. This helps ensure adequate protection against any potential hazards that may be present. Using only basic gloves and a mask (Choice A) may not provide sufficient protection if the hazard is more severe. Opting for respiratory protection only (Choice C) may leave other areas of the body vulnerable to exposure. While asking a colleague for advice (Choice D) is good practice in general, in urgent situations like mass-casualty incidents with unknown hazards, it is crucial to prioritize immediate protection by selecting the highest level of PPE.

5. A nurse is providing education on the use of aspirin. Which of the following should be included?

• A. It can increase the risk of bleeding
• B. It is safe to give to children
• C. It should be taken on an empty stomach
• D. It has no side effects

Correct answer: A

Rationale: The correct answer is A: 'It can increase the risk of bleeding.' Aspirin is known to have antiplatelet effects and can increase the risk of bleeding, especially if taken in high doses or for prolonged periods. Choice B is incorrect because aspirin is not safe for children due to the risk of Reye's syndrome. Choice C is incorrect because aspirin should be taken with food to minimize gastrointestinal side effects. Choice D is incorrect because aspirin, like any medication, can have side effects, such as gastrointestinal bleeding, ulcers, or allergic reactions.

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