Nursing Elites

1. After administering enoxaparin (Lovenox) subcutaneously into the abdomen, which action should the nurse take?

• A. Gently rub the injection site after removing the needle
• B. Have the client maintain a side-lying position for at least five minutes
• C. Remove the needle and engage the needle safety device
• D. Apply heat to the injection site

Correct answer: C

Rationale: After administering a subcutaneous injection of enoxaparin (Lovenox) into the abdomen, the nurse should remove the needle and engage the needle safety device. Rubbing the injection site after the needle is withdrawn is not recommended as it may cause irritation and bruising. Having the client maintain a side-lying position for at least five minutes is unnecessary for a subcutaneous injection into the abdomen. Applying heat to the injection site is not indicated after administering enoxaparin subcutaneously; it could increase the risk of bleeding or bruising at the injection site.

2. The nurse is teaching a community health class for cancer prevention and screening. Which individual has the highest risk for colon cancer?

• A. Client with irritable bowel syndrome
• B. Family history of colon polyps
• C. Client with cirrhosis of the liver
• D. History of colon surgery

Correct answer: B

Rationale: A family history of colon polyps and/or colon cancer is a significant risk factor for developing colon cancer. Individuals with a family history are more likely to develop colon cancer due to genetic predisposition. While other factors like irritable bowel syndrome, cirrhosis of the liver, and history of colon surgery may contribute to an increased risk of colon cancer, having a family history of colon polyps is the highest risk factor. Irritable bowel syndrome does not directly increase the risk of colon cancer. Cirrhosis of the liver is associated with liver cancer rather than colon cancer. A history of colon surgery may reduce the risk of colon cancer in some cases by removing precancerous polyps.

3. The client asked about the role of leptin in the body. Which response should the nurse provide?

• A. It increases food intake in clients, thereby promoting obesity.
• B. It assists in the regulation of steroids.
• C. It increases the total fat mass of people who are obese.
• D. It might decrease the total fat mass in the bodies of people who are obese.

Correct answer: D

Rationale: Leptin is a protein hormone expressed in fat cells that regulates fat cell percentage in the body. It is associated with increased energy expenditure and decreased food intake through hypothalamic control. In obese individuals, there may be insensitivity or resistance to leptin's effects. Leptin influences other hormones like insulin and genetic factors related to fat regulation. Therefore, the correct response is that leptin might decrease total fat mass in obese individuals as it is involved in energy balance and fat regulation. Choices A, B, and C are incorrect because leptin does not increase food intake or promote obesity; it does not assist in the regulation of steroids, and it does not increase total fat mass in people who are obese.

4. Which of the following should be included in a diet rich in iron?

• A. peaches, eggs, beef
• B. cereals, kale, cheese
• C. red beans, enriched breads, squash
• D. legumes, green beans, eggs

Correct answer: A

Rationale: The correct answer is peaches, eggs, beef. These are good sources of heme iron, which is more easily absorbed by the body compared to nonheme iron. Heme iron is mainly found in animal-based foods like meat, poultry, and fish. Peaches, eggs, and beef are rich in iron and can help prevent iron deficiency anemia. Choices B, C, and D are incorrect because they do not include significant sources of heme iron. Cereals, kale, cheese, red beans, enriched breads, squash, legumes, and green beans are sources of nonheme iron, which is not as efficiently absorbed by the body as heme iron. It is important to include heme iron sources in the diet for optimal iron absorption.

5. A healthcare professional is reviewing a patient's ECG report. The patient exhibits a flat T wave, depressed ST segment, and short QT interval. Which of the following medications can cause all of the above effects?

• A. Morphine
• B. Atropine
• C. Procardia
• D. Digitalis

Correct answer: D

Rationale: The correct answer is Digitalis. Digitalis is known to cause a flat T wave, depressed ST segment, and a short QT interval on an ECG report. These ECG changes are characteristic of digitalis toxicity. Morphine is not typically associated with these ECG changes. Atropine is more commonly linked to increasing heart rate rather than causing these specific ECG abnormalities. Procardia is a calcium channel blocker that does not typically produce the described ECG findings. Therefore, Digitalis is the most likely medication causing these effects in the patient.

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