Nursing Elites

1. Medication for treating high blood cholesterol levels should not be used for most people unless:

• A. The patient has at least three major risk factors for coronary heart disease
• B. The patient has been experiencing symptoms of coronary heart disease for at least three months
• C. The patient's medical insurance covers prescription drugs
• D. Treatment with Therapeutic Lifestyle Changes (TLC) alone is unsuccessful after three months

Correct answer: D

Rationale: The correct answer is choice D because medication for high cholesterol is typically not considered unless Therapeutic Lifestyle Changes (TLC), which include diet and exercise, have not proven effective after a three-month period. This approach ensures that lifestyle modifications are given a fair chance to lower cholesterol levels before resorting to medication. Choice A is incorrect because the number of risk factors for coronary heart disease does not dictate when to begin medication; it is about the effectiveness of lifestyle changes. Choice B is incorrect as the duration of coronary heart disease symptoms does not determine when to start medication; the focus is on the response to TLC. Choice C is incorrect because the coverage of prescription drugs by the patient's insurance does not influence the medical decision to use medication for high cholesterol; it is based on medical necessity and effectiveness of prior interventions.

2. The preferred route of administration of medication in the most acute care situations is which of the following routes?

• A. Intravenous C. Subcutaneous
• B. Epidural D. Intramuscular
• C.
• D.

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

3. How many calories does one pound of fat equal?

• A. 1500 calories
• B. 2500 calories
• C. 3500 calories
• D. 5000 calories

Correct answer: C

Rationale: One pound of body fat is equivalent to approximately 3500 calories. This is a generally accepted caloric value used in nutrition and weight management. It's important to note that this is an estimation and individual variations may occur. Choice A (1500 calories), Choice B (2500 calories), and Choice D (5000 calories) are incorrect because they do not match the generally accepted caloric value of 3500 calories for one pound of body fat.

4. Which of the following interventions should be considered the highest priority when caring for June, who has hemiparesis secondary to a stroke?

• A. Position June in an upright lateral position
• B. Perform range of motion exercises
• C. Apply antiembolic stockings
• D. Use hand rolls or pillows for support

Correct answer: C

Rationale: The correct answer is C, 'Apply antiembolic stockings'. In the case of a patient who has experienced a stroke and is suffering from hemiparesis, the highest priority intervention is to prevent further complications such as deep vein thrombosis (DVT), which can be life-threatening. Antiembolic stockings are used to increase venous blood flow velocity and reduce the risk of DVT. Choice 'A', positioning June in an upright lateral position, while important for overall care, is not the highest priority. Choice 'B', performing range of motion exercises, is an important part of recovery but not the immediate priority. Choice 'D', using hand rolls or pillows for support, is also a valuable intervention but does not address the most pressing risk of further complications.

5. Which of the following terms refers to a process by which an individual receives education about the recognition of stress reactions and management strategies for handling stress, which may be instituted after a disaster?

• A. Critical incident stress management
• B. Follow-up
• C. Debriefing
• D. Defusion

Correct answer: A

Rationale: Critical incident stress management is a process that provides individuals with education about recognizing stress reactions and strategizing management techniques for handling stress after a disaster. Choice B, 'Follow-up', is incorrect because it generally refers to continuing care after initial treatment, not specifically to stress management education. Choice C, 'Debriefing', is a process where individuals involved in a critical event are brought together to discuss the event and their reactions to it. It can be part of the critical incident stress management process, but it doesn't cover the whole process. Choice D, 'Defusion', is a technique used in the immediate aftermath of a traumatic event to help individuals process their experiences, but it does not encompass the full range of education about stress recognition and management strategies.

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