Nursing Elites

1. An adolescent client has bloodshot eyes, a voracious appetite, and dry mouth. Which drug abuse would the nurse most likely suspect?

• A. Marijuana
• B. Amphetamines
• C. Barbiturates
• D. Anxiolytics

Correct answer: A

Rationale: The symptoms described, including bloodshot eyes, a voracious appetite, and dry mouth, are consistent with marijuana use. Bloodshot eyes are a common side effect of marijuana due to its effect on blood vessels in the eyes. Marijuana also often causes an increase in appetite (known as 'the munchies') and can result in dry mouth. Amphetamines typically cause symptoms like increased alertness, energy, and decreased appetite. Barbiturates and anxiolytics would not typically cause bloodshot eyes, a voracious appetite, and dry mouth as described in the scenario. Therefore, the most likely drug abuse the nurse would suspect in this case is marijuana.

2. A client is being taught how to follow a low-purine diet for gout management. Which statement indicates the client understands the teaching?

• A. "I will need to limit the number of fruit servings each day."?
• B. "I should avoid eating liver and other organ meats."?
• C. "I can drink only white wine."?
• D. "I should choose red meat instead of poultry."?

Correct answer: B

Rationale: The correct answer is B. Organ meats like liver are high in purines, which can exacerbate gout symptoms. Choosing to avoid such foods is essential in following a low-purine diet. Option A is incorrect because fruits are generally low in purines and are not usually restricted in a low-purine diet. Option C is incorrect as white wine, just like other types of alcohol, should be consumed in moderation or avoided due to its purine content. Option D is incorrect because red meat, including beef and lamb, is high in purines and should be limited in a low-purine diet.

3. Each statement is true of rickets, except one. Which is the exception?

• A. Rickets is being diagnosed more frequently in the United States.
• B. Rickets is caused by vitamin C deficiency.
• C. Tachetic deformities such as bow legs or knock-knees develop.
• D. A narrow and distorted chest occurs.

Correct answer: B

Rationale: Rickets is caused by vitamin D deficiency, not vitamin C deficiency. It usually occurs in children who are 1 to 3 years old. The name rickets came from the word 'wrikken,' meaning 'to bend or twist.' Common manifestations of rickets include tachetic deformities like bow legs or knock-knees, a narrow and distorted chest, and failure of the epiphyses of bones to develop normally, resulting in twisted and warped bones. While the diagnosis of rickets may be increasing in the United States, it is not caused by a lack of vitamin C.

4. When documenting outcome of Richard’s treatment Mario should include the following in his recording EXCEPT:

• A. Color, amount and consistency of sputum
• B. Character of breath sounds and respiratory rate before and after procedure
• C. Amount of fluid intake of client before and after the procedure
• D. Significant changes in vital signs

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

5. A nurse is teaching a group of clients about stress. Which of the following should the nurse include in the teaching?

• A. Protein requirements decrease in times of stress.
• B. Acute stress causes an increase in metabolism.
• C. Stress causes a positive nitrogen balance in the body.
• D. Glucose is broken down more slowly during times of stress.

Correct answer: B

Rationale: The correct answer is B: Acute stress causes an increase in metabolism. During acute stress, the body's fight-or-flight response is activated, leading to an increase in metabolism to provide energy for the body to respond to the stressor. Choices A, C, and D are incorrect. Protein requirements actually increase during times of stress to support the body's needs. Stress typically leads to a negative nitrogen balance in the body, not a positive one. Glucose is broken down more rapidly, not slowly, during times of stress to provide immediate energy.

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