Nursing Elites

1. What influences health status?

• A. lifestyle choices and community resources
• B. availability of health technology like diagnostic machines
• C. presence of toxic environmental conditions
• D. all of the above

Correct answer: D

Rationale: Health status is influenced by a combination of lifestyle choices, community resources, health technology like diagnostic machines, and environmental conditions. Each of these factors plays a role in determining an individual's overall health. Choice A is correct as lifestyle choices (such as diet, exercise, and smoking habits) and access to community resources (like healthcare facilities, support groups, and recreational spaces) are important determinants of health. Choice B is correct as the availability of health technology, including diagnostic machines, can impact early detection and treatment of health conditions. Choice C is correct as exposure to toxic environmental conditions (such as pollution, contaminated water, or hazardous waste) can have adverse effects on health. Therefore, the correct answer is D because all of these factors collectively influence health status.

2. As a client who is terminally ill has been receiving high doses of an opioid analgesic for the past month and becomes unresponsive to verbal stimuli as death approaches, what orders would the nurse expect from the healthcare provider?

• A. Decrease the analgesic dosage by half
• B. Discontinue the analgesic
• C. Continue the same analgesic dosage
• D. Prescribe a less potent drug

Correct answer: C

Rationale: Continuing the same dosage of analgesic is appropriate to manage pain effectively as death nears and the client becomes unresponsive. The primary goal of palliative care in end-of-life situations is to ensure comfort, regardless of the client's level of consciousness. Decreasing the analgesic dosage or discontinuing it could lead to inadequate pain relief, which goes against the principles of palliative care. Prescribing a less potent drug may also compromise pain management in this critical stage. Therefore, maintaining the same analgesic dosage is the most appropriate action to provide comfort and alleviate suffering.

3. A client with heart failure is receiving digoxin (Lanoxin). The nurse should monitor the client for which of the following signs of digoxin toxicity?

• A. Tachycardia
• B. Hypotension
• C. Bradycardia
• D. Hyperglycemia

Correct answer: C

Rationale: The correct answer is C: Bradycardia. Digoxin toxicity often presents with bradycardia, which is a common sign of toxicity associated with this medication. Tachycardia (Choice A) is not typically seen with digoxin toxicity. Hypotension (Choice B) can occur but is less specific to digoxin toxicity. Hyperglycemia (Choice D) is not a typical sign of digoxin toxicity. Therefore, monitoring for bradycardia is crucial in clients receiving digoxin to detect toxicity early.

4. What title should be given to this role in occupational health? An advanced practice nurse who provides workers with primary care services with an emphasis on the diagnosis and management of common acute illnesses/injuries and stable chronic diseases.

• A. case manager
• B. nurse consultant
• C. clinician nurse practitioner
• D. health promotion specialist

Correct answer: C

Rationale: The correct title for this role is a clinician nurse practitioner as they provide primary care services, including diagnosing and managing illnesses. Choice A, case manager, typically focuses on coordinating care and services for patients. Choice B, nurse consultant, involves providing expert advice and guidance. Choice D, health promotion specialist, concentrates on promoting health and preventing diseases rather than diagnosing and treating illnesses.

5. While caring for a client with infective endocarditis, the nurse must be alert for signs of pulmonary embolism. Which of the following assessment findings suggests this complication?

• A. Positive Homan's sign
• B. Fever and chills
• C. Dyspnea and cough
• D. Sensory impairment

Correct answer: C

Rationale: The correct answer is C: 'Dyspnea and cough.' Pulmonary embolism often presents with a sudden onset of dyspnea (difficulty breathing) and cough, which are due to the obstruction of blood flow in the pulmonary arteries. Choices A, B, and D are incorrect. Positive Homan's sign is associated with deep vein thrombosis, fever and chills are nonspecific symptoms commonly seen in infective endocarditis, and sensory impairment is not typically indicative of pulmonary embolism.

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