Nursing Elites

1. Why is morphine administered to a patient with a myocardial infarction (MI)?

• A. To reduce pain.
• B. To decrease anxiety.
• C. To reduce cardiac workload.
• D. To increase respiratory rate.

Correct answer: C

Rationale: Morphine is administered to a patient with a myocardial infarction (MI) primarily to reduce cardiac workload. By reducing preload and afterload, morphine helps improve oxygenation to the heart muscle. This decrease in workload on the heart can alleviate symptoms and reduce strain on the heart muscle during an MI. Choices A and B are incorrect because the primary goal of administering morphine in this context is not pain relief or anxiety reduction. Choice D is incorrect as morphine does not aim to increase respiratory rate but rather to address the cardiac workload.

2. In a patient with chronic kidney disease (CKD) receiving erythropoietin therapy, what laboratory result should the nurse monitor to evaluate the effectiveness of this therapy?

• A. Serum creatinine
• B. White blood cell count
• C. Hemoglobin level
• D. Serum potassium

Correct answer: C

Rationale: The correct answer is C: Hemoglobin level. Erythropoietin therapy is used to stimulate red blood cell production in patients with chronic kidney disease who often develop anemia due to reduced erythropoietin production by the kidneys. Monitoring the hemoglobin level is essential to evaluate the effectiveness of erythropoietin therapy as an increase in hemoglobin indicates improved red blood cell production and better management of anemia in these patients. Serum creatinine, white blood cell count, and serum potassium levels are important parameters to monitor in CKD patients but are not specific indicators of the effectiveness of erythropoietin therapy for managing anemia.

3. A client with chronic kidney disease (CKD) has an arteriovenous (AV) fistula for hemodialysis. Which finding should the nurse report to the healthcare provider immediately?

• A. No bruit or thrill over the AV fistula.
• B. Redness at the site of the AV fistula.
• C. Client's complaint of pain at the AV fistula site.
• D. Swelling of the hand on the side of the AV fistula.

Correct answer: A

Rationale: In a client with a chronic kidney disease who has an arteriovenous (AV) fistula for hemodialysis, the absence of a bruit (a humming sound) or thrill (vibratory sensation) over the AV fistula indicates a potential occlusion. This finding suggests inadequate blood flow through the AV fistula, which is a critical issue requiring immediate intervention to prevent complications such as thrombosis or clot formation. Reporting this absence of bruit or thrill promptly to the healthcare provider is essential to ensure timely assessment and management to maintain vascular access for hemodialysis.

4. A client with a history of chronic alcohol abuse is at risk for which of the following conditions?

• A. Liver cirrhosis
• B. Renal failure
• C. Chronic obstructive pulmonary disease (COPD)
• D. Peptic ulcer disease

Correct answer: A

Rationale: Chronic alcohol abuse can lead to liver cirrhosis due to long-term liver damage. Alcohol consumption over time can cause inflammation and scarring of the liver, eventually leading to cirrhosis. This condition can severely impact liver function and may progress to liver failure if not addressed.

5. When should the charge nurse intervene based on the observed behavior?

• A. Two staff members are overheard talking about a cure for AIDS outside a client's room.
• B. A hospital transporter is reading a client's history and physical while waiting for an elevator.
• C. A UAP tells a client, 'It's hard to quit drinking but Alcoholics Anonymous helped me.'
• D. Two visitors are discussing a hospitalized client's history of drug abuse in the visitor's lounge.

Correct answer: B

Rationale: The hospital transporter reading a client's history and physical without a legitimate need violates patient confidentiality. This behavior requires immediate intervention to protect the client's privacy and confidentiality rights.

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