Nursing Elites

1. When administering NSAID adjunctive therapy to an elderly client with cancer, the nurse must monitor:

• A. BUN and creatinine.
• B. creatinine and calcium.
• C. Hgb and Hct.
• D. BUN and CFT.

Correct answer: A

Rationale: When an elderly client with cancer is receiving NSAID therapy, monitoring BUN (blood urea nitrogen) and creatinine levels is crucial. NSAIDs can cause renal toxicity, especially in the elderly. BUN and creatinine levels help assess renal function and detect early signs of renal impairment. Monitoring creatinine alone (Choice B) is not sufficient as BUN provides complementary information about renal function. Monitoring hemoglobin (Hgb) and hematocrit (Hct) (Choice C) is important for assessing anemia but not specific to NSAID therapy in the elderly. CFT (Choice D) is not a standard abbreviation in this context, and monitoring coagulation function is not directly related to NSAID therapy in this scenario.

2. Which of the following medications might cause upper-gastrointestinal (UGI) bleeding?

• A. Cardizem (diltiazem)
• B. Naprosyn (naproxen)
• C. Elavil (amitriptyline)
• D. Corgard (nadolol)

Correct answer: C

Rationale: Naprosyn (naproxen) is known to cause upper-gastrointestinal (UGI) bleeding due to its effects on the stomach lining. Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that can irritate the stomach and increase the risk of UGI bleeding. On the other hand, Cardizem (diltiazem), Elavil (amitriptyline), and Corgard (nadolol) are not typically associated with UGI bleeding. Cardizem is a calcium channel blocker used for hypertension and angina, Elavil is a tricyclic antidepressant, and Corgard is a beta-blocker used for hypertension.

3. When managing nausea related to Morphine epidural analgesia, the nurse should administer:

• A. Indomethacin
• B. Codeine
• C. Ibuprofen
• D. Compazine

Correct answer: D

Rationale: When managing nausea related to Morphine epidural analgesia, Compazine is the appropriate medication to administer. Compazine, also known as prochlorperazine, is commonly used to treat nausea and vomiting. It works by affecting certain chemicals in the brain that trigger nausea and vomiting. Choices A, B, and C are incorrect because Indomethacin, Codeine, and Ibuprofen are not typically used to manage nausea associated with Morphine epidural analgesia.

4. Several passengers aboard an airliner suddenly become weak and suffer breathing difficulty. The diagnosis is likely to be

• A. Outbreak of Asian flu.
• B. Chemical exposure.
• C. Bacterial pneumonia.
• D. Allergic reaction.

Correct answer: B

Rationale: In the scenario described, where multiple passengers on an airliner experience sudden weakness and breathing difficulty simultaneously, the most likely cause is chemical exposure. This is because a sudden onset of similar symptoms in a group of individuals suggests a common environmental factor affecting them. Options A, C, and D are less likely as they do not explain a sudden onset of symptoms in multiple individuals simultaneously. Asian flu (Option A) is a viral infection and would not typically result in sudden symptoms in multiple individuals at the same time. Bacterial pneumonia (Option C) is a localized infection and not a probable cause for a sudden onset of symptoms in a group. An allergic reaction (Option D) would usually occur in individuals with specific allergies rather than affecting a group of passengers at the same time.

5. Which of the following activities is not part of client advocacy?

• A. involving the client in treatment and decision-making
• B. standing up for what is right for the client
• C. sharing your personal opinions to help provide additional information
• D. encouraging the client to advocate for themselves

Correct answer: C

Rationale: The correct answer is 'sharing your personal opinions to help provide additional information.' Client advocacy involves supporting the client's autonomy and choices. It is essential for the nurse to involve the client in treatment and decision-making (Choice A) to ensure their preferences are considered. Standing up for what is right for the client (Choice B) is also a crucial aspect of advocacy, ensuring their rights and well-being are protected. Encouraging the client to advocate for themselves (Choice D) empowers the client to express their needs. However, sharing personal opinions (Choice C) may influence the client's decision-making process and is not a recommended practice in client advocacy, as it can compromise the client's autonomy.

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