Nursing Elites

1. Mrs. Owens is the 81-year-old mother of Jonathan, who is 54 years old. Jonathan has had schizophrenia since he was 16 years old. Which of Mrs. Owens's concerns is likely to predominate?

• A. "Will my retirement funds outlast me?"?
• B. "Who will handle my funeral arrangements?"?
• C. "What will become of Jonathan when I am gone?"?
• D. "How can I communicate effectively with Jonathan's physician?"?

Correct answer: C

Rationale: The most prominent concern for Mrs. Owens is likely what will happen to her son, Jonathan, after she passes away. While retirement fund sustainability is important, it is not likely to be her primary concern. Funeral arrangements, although significant, are secondary to the welfare of her son with schizophrenia. The question of how to communicate with Jonathan's physician is less likely to be a predominant concern since Mrs. Owens has likely already addressed this issue over the 38 years of managing her son's care.

2. The nurse is making assignments for the day. Which client should be assigned to the nursing assistant?

• A. A client with Alzheimer's disease
• B. A client with pneumonia
• C. A client with appendicitis
• D. A client with thrombophlebitis

Correct answer: A

Rationale: The client with Alzheimer's disease is the most stable among the clients listed and can be appropriately assigned to the nursing assistant. Nursing assistants are capable of providing care such as feeding and assisting with activities of daily living for individuals with Alzheimer's disease. Clients with pneumonia, appendicitis, and thrombophlebitis are less stable and necessitate the expertise of a registered nurse for accurate assessment and interventions. Therefore, the nursing assistant can effectively care for the client with Alzheimer's disease while ensuring that the other clients receive the necessary level of care from a registered nurse.

3. A 20-year-old female has a prescription for tetracycline. While teaching the client how to take her medicine, the nurse learns that the client is also taking Ortho-Novum oral contraceptive pills. Which instructions should be included in the teaching plan?

• A. The oral contraceptives will decrease the effectiveness of the tetracycline.
• B. Nausea often results from taking oral contraceptives and antibiotics.
• C. Toxicity can result when taking these two medications together.
• D. Antibiotics can decrease the effectiveness of oral contraceptives, so the client should use an alternate method of birth control.

Correct answer: D

Rationale: When antibiotics and oral contraceptives are taken together, the effectiveness of the oral contraceptives can be reduced, increasing the risk of pregnancy. Therefore, it is important to advise the client to use an alternate method of birth control to prevent unintended pregnancy. Choices A, B, and C are incorrect because there is no evidence to suggest that oral contraceptives decrease the effectiveness of tetracycline, cause nausea, or result in toxicity when taken with antibiotics.

4. A 12-year-old male is brought to his primary care provider to determine whether sexual abuse has occurred. The mother states, 'Because there is no permanent physical damage, he does not need any more treatment.' The nurse's response should be based on which of the following pieces of information?

• A. Male victims of sexual abuse can have long-term psychological problems.
• B. Survivors of male sexual abuse might become confused about their sexual identity.
• C. Unless treated, all male sex abuse survivors grow up to abuse other children.
• D. All children who have been sexually abused have the same needs, regardless of gender.

Correct answer: B

Rationale: Male children are sexually abused nearly as often as female children. Perpetrators are usually men but can be women. Needs of male children who have been sexually abused might be different from the needs of female survivors. Male survivors might respond in anger, question their sexuality, use alcohol and other drugs, and might try to prove their masculinity by performing daring acts. It is crucial for the nurse to consider these potential outcomes, making choice B the correct answer. Choice A is incorrect because male victims of sexual abuse can indeed have long-term psychological problems, so the nurse should be aware of this issue. Choice C is incorrect as not all male sex abuse survivors grow up to abuse other children, which is a misconception. Choice D is incorrect because the needs of children who have been sexually abused can vary based on various factors, including gender, so it is important to consider individual differences.

5. A client with cancer is admitted to the oncology unit. Stat lab values reveal Hgb 12.6, WBC 6500, K+ 1.9, uric acid 7.0, Na+ 136, and platelets 178,000. The nurse evaluates that the client is experiencing which of the following?

• A. Hypernatremia
• B. Hypokalemia
• C. Myelosuppression
• D. Leukocytosis

Correct answer: B

Rationale: The correct answer is 'Hypokalemia.' The potassium level of 1.9 indicates low potassium levels, a condition known as hypokalemia. The other lab values are within normal ranges: Hgb 12.6, WBC 6500, uric acid 7.0, Na+ 136, and platelets 178,000. Hypernatremia (choice A) refers to high sodium levels, which are not present in this case. Myelosuppression (choice C) is a decrease in bone marrow activity, which is not indicated by the lab values provided. Leukocytosis (choice D) is an increase in white blood cells, which is also not present based on the given values.

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