Nursing Elites

1. When a patient is prescribed an oral anticoagulant, what should the nurse monitor for?

• A. Elevated blood glucose
• B. Decreased blood pressure
• C. Signs of bleeding
• D. Increased appetite

Correct answer: C

Rationale: When a patient is prescribed an oral anticoagulant, the nurse should monitor for signs of bleeding. Oral anticoagulants work by inhibiting the blood's ability to clot, which increases the risk of bleeding. Monitoring for signs of bleeding such as easy bruising, petechiae, hematuria, or bleeding gums is crucial to prevent complications. Elevated blood glucose (Choice A) is not directly related to oral anticoagulant use. Decreased blood pressure (Choice B) is not a common effect of oral anticoagulants. Increased appetite (Choice D) is not a typical side effect of oral anticoagulants and is not a primary concern when monitoring a patient on this medication.

2. A client with type 1 diabetes is diagnosed with diabetic ketoacidosis and initially treated with intravenous fluids followed by an IV bolus of regular insulin. The nurse anticipates that the practitioner will prescribe a continuous infusion of insulin of:

• A. Novolin L insulin
• B. Novolin R insulin
• C. Novolin N insulin
• D. Novolin U insulin

Correct answer: B

Rationale: The correct answer is Novolin R (Regular insulin). Regular insulin is used for continuous infusion to treat diabetic ketoacidosis due to its rapid onset of action. Novolin L (Intermediate-acting insulin) (choice A), Novolin N (Intermediate-acting insulin) (choice C), and Novolin U (Ultra-Long-acting insulin) (choice D) are not suitable for continuous infusion in the treatment of diabetic ketoacidosis.

3. The nurse in the pediatric clinic performs a physical assessment of a 13-year-old boy. Which of the following findings by the nurse requires an immediate intervention?

• A. The adolescent complains of his scrotum aching after exercise. The nurse palpates a worm-like mass above the testes
• B. The nurse noted unilateral breast enlargement
• C. The child’s scrotum appears swollen, and a soft mass is palpated. The nurse is unable to insert a finger above the mass
• D. The child’s scrotum appears enlarged and red. The nurse palpated a thickened and swollen spermatic cord.

Correct answer: D

Rationale: A swollen and thickened spermatic cord could indicate testicular torsion, which is a surgical emergency.

4. Which of the following describes the four-step method of assessment, planning, implementation, and evaluation?

• A. It is a problem-focused process of continued nursing care
• B. It is an open-ended process of continued nursing care
• C. It is a circular process of continued nursing care
• D. It is a trial-and-error process of continued nursing care

Correct answer: C

Rationale: The correct answer is C: 'It is a circular process of continued nursing care.' The four-step method of assessment, planning, implementation, and evaluation is a continuous and cyclical process in nursing care. Choice A is incorrect because the method is not solely problem-focused but involves multiple steps. Choice B is incorrect as it does not capture the structured nature of the four-step method. Choice D is incorrect as it implies a random approach rather than a systematic and organized process.

5. Which of the following nursing interventions is important for a client scheduled to have a Guaiac Test?

• A. Avoid turnips, radish, and horseradish 3 days before
• B. Continue iron preparation to prevent further loss
• C. Do not consume meat 12 hours before the procedure
• D. Encourage consumption of caffeine and dark-colored foods

Correct answer: A

Rationale: The correct answer is A. Turnips, radish, and horseradish are known to cause false-positive results in a Guaiac Test, which is used to detect blood in the stool. Avoiding these foods is crucial to ensure accurate test results. Choice B is incorrect as iron preparation is not directly related to the Guaiac Test. Choice C is incorrect because avoiding meat is not specifically necessary before a Guaiac Test. Choice D is incorrect as caffeine and dark-colored foods can potentially interfere with test results, so they should not be encouraged.

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