Nursing Elites

1. How should a healthcare provider handle a patient with non-compliance to hypertension medication?

• A. Provide education about medication
• B. Refer the patient to a specialist
• C. Explore alternative treatments
• D. Reassess the patient in 6 months

Correct answer: A

Rationale: Providing education about the importance of medication adherence is crucial in managing hypertension. By educating the patient about the significance of taking their medication as prescribed, the healthcare provider can help improve compliance and control the patient's blood pressure. Referring the patient to a specialist (Choice B) may be necessary in some cases but addressing non-compliance should start with education. Exploring alternative treatments (Choice C) could be considered if the current medication is not suitable, but initial steps should focus on improving adherence. Reassessing the patient in 6 months (Choice D) may be too delayed if non-compliance is an issue that needs immediate attention.

2. A nurse is assessing a client who is experiencing acute pain. Which of the following manifestations should the nurse expect?

• A. Hypertension
• B. Bradycardia
• C. Diaphoresis
• D. Piloerection

Correct answer: C

Rationale: The correct answer is C: Diaphoresis. Diaphoresis, which is excessive sweating, is a common manifestation of acute pain caused by increased sympathetic nervous system activity. This response is the body's way of trying to regulate body temperature during the stress response. Choices A, B, and D are incorrect. Hypertension (Choice A) and tachycardia (not bradycardia as in Choice B) are more likely responses to acute pain due to sympathetic nervous system activation. Piloerection (Choice D), also known as goosebumps, is not a typical manifestation of acute pain.

3. A nurse is caring for a client who has septic shock. Which of the following findings should the nurse report to the provider?

• A. Temperature of 38°C (100.4°F).
• B. Urinary output of 40 mL/hr.
• C. Heart rate of 92/min.
• D. Capillary refill time of 2 seconds.

Correct answer: B

Rationale: The correct answer is B. A urinary output of 40 mL/hr is below the expected range and should be reported to the provider as it may indicate impaired kidney function, which is crucial to monitor in a client with septic shock. Choices A, C, and D are within acceptable ranges for a client with septic shock and do not indicate immediate concerns. A temperature of 38°C (100.4°F) is slightly elevated but can be expected in septic shock. A heart rate of 92/min is within the normal range for an adult. A capillary refill time of 2 seconds is also normal, indicating adequate peripheral perfusion.

4. A nurse is caring for a client who is 1 day postoperative following a total knee replacement. Which of the following findings should the nurse report to the provider?

• A. Heart rate of 88/min
• B. Serous drainage on the dressing
• C. Temperature 37.3°C (99.1°F)
• D. Calf pain on dorsiflexion

Correct answer: D

Rationale: The correct answer is D. Calf pain on dorsiflexion following knee surgery may indicate a complication such as deep vein thrombosis, which is a serious condition requiring medical attention. Reporting this finding promptly is crucial to prevent further complications. Choices A, B, and C are within normal range for a client post knee surgery and do not typically indicate immediate complications that require urgent reporting.

5. What is the priority nursing intervention for a patient experiencing a myocardial infarction?

• A. Administer aspirin
• B. Administer nitroglycerin
• C. Administer morphine
• D. Prepare for surgery

Correct answer: A

Rationale: The correct answer is to administer aspirin. Administering aspirin is a priority nursing intervention for a patient experiencing a myocardial infarction because it helps reduce the risk of further clot formation. Aspirin is a common medication given during the early stages of a heart attack to prevent additional clotting. Administering nitroglycerin may also be indicated to help relieve chest pain by dilating blood vessels, but aspirin takes precedence due to its role in preventing clot progression. Administering morphine is not typically the first intervention in myocardial infarction as it can mask symptoms and delay other critical treatments. Surgery is not an immediate priority in the initial management of a myocardial infarction.

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