Nursing Elites

1. Which of the following enzymes is indicative of pancreatitis?

• A. alkaline phosphatase
• B. acid phosphatase
• C. creatine phosphokinase
• D. amylase

Correct answer: D

Rationale: Amylase is elevated in conditions of pancreatic inflammation, such as pancreatitis. Pancreatitis is characterized by the inflammation of the pancreas, leading to the leakage of amylase into the bloodstream. Elevated levels of amylase are a key diagnostic marker for pancreatitis. Alkaline phosphatase is associated with liver and bone conditions, not pancreatitis. Acid phosphatase is more related to prostate health and is not specific to pancreatitis. Creatine phosphokinase is found in tissues like muscle and brain, and elevated levels are seen in conditions like muscle injury or heart attack, not pancreatitis.

2. The healthcare provider is using Cognitive-Behavioral methods of pain control and knows that these methods can be expected to do all the following except:

• A. completely relieve all pain.
• B. provide benefit by restoring the client's sense of self-control.
• C. help the client to control symptoms.
• D. help the client actively participate in his or her care.

Correct answer: A

Rationale: Cognitive-Behavioral methods of pain control aim to provide benefit by restoring the client's sense of self-control, helping the client to control symptoms, and encouraging the client to actively participate in their care. However, these methods are not intended to completely relieve all pain. These interventions focus on perception and thought, aiming to influence how one interprets events and bodily sensations. Therefore, the correct answer is that they cannot completely relieve all pain, as pain relief is often a multifaceted approach that may require additional interventions beyond Cognitive-Behavioral methods. Choices B, C, and D are correct as Cognitive-Behavioral methods are designed to empower the individual in managing their pain and improving their overall well-being.

3. While assisting a healthcare provider in assessing a hospitalized client, the healthcare provider is paged to report to the recovery room. The healthcare provider instructs the nurse verbally to change the solution and rate of the intravenous (IV) fluid being administered. What is the most appropriate nursing action in this situation?

• A. Calling the nursing supervisor to obtain permission to accept the verbal prescription
• B. Asking the healthcare provider to write the prescription in the client's record before leaving the nursing unit
• C. Telling the healthcare provider that the prescription will not be implemented until it is documented in the client's record
• D. Changing the solution and rate of the IV fluid per the healthcare provider's verbal prescription

Correct answer: B

Rationale: Verbal prescriptions should be avoided due to the risk of errors. If a verbal prescription is necessary, it should be promptly written and signed by the healthcare provider, typically within 24 hours. Following agency policies and procedures regarding verbal prescriptions is crucial. In this scenario, the most appropriate nursing action is to request the healthcare provider to document the prescription in the client's record before leaving the unit. Calling the nursing supervisor to accept the verbal prescription without documentation, telling the healthcare provider to delay treatment until documented, and directly changing the IV fluid based on verbal orders all pose risks and do not align with best practices in medication administration.

4. An LPN is working on the care plan for a client with diabetes mellitus. Which of these outcomes would be the most appropriate?

• A. The client will maintain a blood glucose level within the normal range of 70-110 (per facility policy) throughout my shift.
• B. The client will maintain a blood glucose level within normal range limits today.
• C. The client will maintain a blood glucose level within the normal range of 70-110 (per facility policy) throughout my shift.
• D. The client will maintain a blood glucose level within normal limits throughout my shift.

Correct answer: C

Rationale: The correct answer is 'The client will maintain a blood glucose level within the normal range of 70-110 (per facility policy) throughout my shift.' This outcome is specific, measurable, and aligns with the goal of managing diabetes mellitus. Choice A is correct because it provides a clear target range (70-110) and includes adherence to facility policy, making it precise and goal-oriented. Choice B lacks specificity on the timeframe, and Choice D is vague in defining the target blood glucose range. In nursing care plans, outcomes should be well-defined, achievable, and measurable to effectively monitor the client's progress in managing their condition.

5. When the nurse is determining the appropriate size of an oropharyngeal airway to insert, what part of a client's body should she measure?

• A. corner of the mouth to the tragus of the ear
• B. corner of the eye to the top of the ear
• C. tip of the chin to the sternum
• D. tip of the nose to the earlobe

Correct answer: B

Rationale: Correct! When sizing an oropharyngeal airway, the nurse should measure from the corner of the client's mouth to the tragus of the ear. This measurement ensures that the airway is the appropriate length to reach the pharynx without being too long or too short. Choices B, C, and D are incorrect as they do not provide the correct anatomical landmarks for determining the size of an oropharyngeal airway. Measuring from the corner of the mouth to the tragus of the ear is a standard method to ensure proper airway size and prevent complications during airway management.

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