Nursing Elites

1. While administering penicillin intravenously, you notice that the patient becomes hypotensive with a bounding, rapid pulse rate. What is the first action you should take?

• A. Decrease the rate of the intravenous medication flow.
• B. Increase the rate of the intravenous medication flow.
• C. Call the doctor.
• D. Stop the intravenous flow.

Correct answer: D

Rationale: The correct action to take when a patient becomes hypotensive with a bounding, rapid pulse rate after administering penicillin intravenously is to stop the intravenous flow immediately. This can help prevent further complications by discontinuing the administration of the medication that might be causing the adverse effects. Decreasing or increasing the rate of medication flow may not address the underlying issue of the patient's adverse reaction. While it's important to involve the healthcare provider in such situations, the immediate priority is to halt the administration of the medication.

2. Which of the following is expected to be most likely true in the near future?

• A. Quality improvement projects will decline due to cost-cutting measures.
• B. Alternative and complementary approaches will gain acceptance in medical practice.
• C. Care will primarily shift away from the hospital setting.
• D. Increased focus on care transitions will involve nursing.

Correct answer: D

Rationale: In the near future, there will be an increased focus on care transitions involving nursing. This means that nurses will play a crucial role in preparing patients for transitions between different care settings, ensuring continuity and quality of care. Choice A is incorrect because quality improvement projects are essential and are not expected to decline. Choice B is incorrect as alternative and complementary approaches are increasingly being integrated into medical practice. Choice C is incorrect as there is a growing trend towards providing care in community settings and homes, moving away from primarily hospital-based care.

3. Which of the following is a benefit of the U.S. health-care system?

• A. With cost savings from technology, more Americans now have health-care insurance.
• B. Quality of care has improved in the United States.
• C. Care in the United States has shifted to a prevention focus rather than an illness focus.
• D. The use of technology is projected to decrease health-care costs and improve clinical outcomes.

Correct answer: D

Rationale: The correct answer is D because the use of technology and electronic health records is projected to decrease health-care costs and improve clinical outcomes, quality, and safety. Choice A is incorrect because it states that very few Americans have no health-care insurance, which is not a benefit of the U.S. health-care system. Choice B may be true, but it does not directly address a benefit of the health-care system. Choice C is not necessarily a benefit but rather a shift in focus, so it is also incorrect.

4. You are caring for a patient who has no cognitive functioning but only basic human functions such as opening the eyes and the sleep-wake cycle. What level of consciousness does this patient have?

• A. Obtunded
• B. A persistent vegetative state
• C. Locked-in syndrome
• D. Brain death

Correct answer: B

Rationale: A persistent vegetative state is characterized by the absence of cognitive functioning while basic human functions like the sleep-wake cycle are retained. In this state, the patient shows reflex movements and basic responses to stimuli but lacks awareness or higher mental functions. Choices A, C, and D are incorrect because: A) Obtunded refers to a decreased level of consciousness, not the absence of cognitive functioning. C) Locked-in syndrome is a condition where the patient is aware and awake but cannot move or communicate due to complete paralysis of nearly all voluntary muscles except for vertical eye movements and blinking. D) Brain death is the irreversible cessation of all brain activity, including the brainstem, leading to the loss of all functions of the brain.

5. A healthcare professional is reviewing a client's laboratory report and notes that the serum calcium level is 4.0 mg/dL. The healthcare professional understands that which condition most likely caused this serum calcium level?

• A. Prolonged bed rest
• B. Renal insufficiency
• C. Hyperparathyroidism
• D. Excessive ingestion of vitamin D

Correct answer: A

Rationale: Prolonged bed rest can lead to hypocalcemia due to decreased mobility and bone resorption. In this scenario, the low serum calcium level of 4.0 mg/dL is likely a result of decreased bone activity and calcium release due to prolonged bed rest. Renal insufficiency would more likely lead to hypercalcemia due to impaired excretion of calcium by the kidneys. Hyperparathyroidism is characterized by increased calcium levels as a result of excess parathyroid hormone. Excessive ingestion of vitamin D can cause hypercalcemia by increasing intestinal absorption of calcium.

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