Nursing Elites

1. Select a myth or falsehood relating to pain, pain management, and addiction.

• A. Addiction can be accurately predicted.
• B. Withdrawal, drug tolerance, and physical dependence do not indicate addiction.
• C. Pain medications should be avoided in patients with a substance abuse history.
• D. Addiction is signaled by deception and stockpiling by the client.

Correct answer: A

Rationale: The correct answer is A because addiction cannot be accurately predicted. Choices B and C are incorrect. Withdrawal, drug tolerance, and physical dependence are not definitive signs of addiction, and pain medications can be used with patients who have a substance abuse history under careful monitoring. Choice D is incorrect because addiction is not solely signaled by deception and stockpiling; it is a complex condition with various behavioral, physical, and psychological aspects.

2. A nurse is providing discharge teaching to the parent of a toddler who has a new diagnosis of asthma. The parent states she is unable to afford the nebulizer prescribed for the child. Which of the following referrals should the nurse recommend?

• A. Social worker
• B. Pharmacist
• C. Respiratory therapist
• D. Child protective services

Correct answer: A

Rationale: The correct answer is A: Social worker. A social worker can assist the parent in finding resources to afford the nebulizer. While a pharmacist may provide information about medications and devices, they may not have direct resources to address financial concerns. A respiratory therapist focuses on respiratory care but may not specialize in financial assistance. Referring to child protective services is not appropriate in this scenario as the parent's inability to afford a nebulizer does not indicate neglect or abuse.

3. Which individual is most at risk for Osgood-Schlatter disease?

• A. An elderly female who is hospitalized with a hip fracture and on bed rest
• B. A middle-aged male patient who has been exposed to asbestos in the shipping industry
• C. An adolescent who is physically active and the captain of their soccer team
• D. An infant of low birth weight and a gestational age of 28 weeks

Correct answer: C

Rationale: Osgood-Schlatter disease is a condition that commonly affects adolescents who are physically active, especially during growth spurts. It is caused by overuse of the knee, leading to inflammation of the patellar ligament at the tibial tuberosity. The repetitive stress on the growth plate during activities like running and jumping can trigger this condition. Therefore, an adolescent who is physically active and the captain of their soccer team is most at risk for Osgood-Schlatter disease. Choices A, B, and D are not at high risk for this condition as it is primarily seen in active adolescents.

4. A nurse is caring for a client who has cancer. The client’s adult child asks the nurse for information about the client’s treatment plan. Which of the following responses should the nurse make?

• A. I will ask your mother's primary care provider to speak with you
• B. What would you like to know about your mother's treatment?
• C. I cannot provide this information to you without your mother's consent
• D. You will have to speak directly to your mother about her treatment

Correct answer: C

Rationale: The nurse should not provide treatment information without the client's consent.

5. A client with diabetes experiences Somogyi's effect. To prevent this complication, the nurse should instruct the client to:

• A. Take insulin at 2:00 PM each day
• B. Engage in physical activity daily
• C. Increase the dose of regular insulin
• D. Eat a protein and carbohydrate snack at bedtime

Correct answer: D

Rationale: Somogyi effect, also known as rebound hyperglycemia, occurs as a response to nighttime hypoglycemia. Eating a protein and carbohydrate snack at bedtime can help prevent this by stabilizing blood sugar levels throughout the night. Instructing the client to take insulin at 2:00 PM each day (Choice A) may not directly address the nighttime hypoglycemia concern. Engaging in physical activity daily (Choice B) is generally beneficial for diabetes management but may not specifically prevent Somogyi's effect. Increasing the dose of regular insulin (Choice C) without addressing the nighttime hypoglycemia issue can exacerbate the problem.

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