Nursing Elites

1. The charge nurse on a cardiac unit tells you a patient is exhibiting signs of right-sided heart failure. Which of the following would not indicate right-sided heart failure?

• A. Muscle tetany
• B. Syncope
• C. Numbness
• D. Anxiety

Correct answer: D

Rationale: The correct answer is 'Anxiety.' Anxiety is not a typical sign of right-sided heart failure. Right-sided heart failure usually presents with symptoms such as muscle tetany, syncope, and numbness. Muscle tetany can occur due to electrolyte imbalances seen in heart failure. Syncope can result from decreased cardiac output, leading to decreased perfusion to the brain. Numbness can occur due to poor circulation. While anxiety can be present in patients with various medical conditions, it is more commonly associated with respiratory acidosis or other psychological factors rather than right-sided heart failure.

2. Support systems during the grieving process include all of the following except:

• A. a despondent friend.
• B. a nurse.
• C. a social worker.
• D. a family member.

Correct answer: B

Rationale: During the grieving process, it is essential to have a support system in place. Options B, C, and D - a nurse, a social worker, and a family member, respectively, are individuals who can provide comfort, guidance, and practical assistance to someone who is grieving. However, a despondent friend, as stated in the question, is not an ideal choice for support during this period. A despondent friend is someone who is feeling extremely unhappy and discouraged, and may not have the emotional capacity to provide the needed support to a grieving individual. It is important for someone who is grieving to have support from individuals who can offer understanding, empathy, and strength, which a despondent friend may struggle to provide.

3. A patient asks a nurse the following question: Exposure to TB can be best identified with which of the following procedures?

• A. Chest x-ray
• B. Mantoux test
• C. Breath sounds examination
• D. Sputum culture for Mycobacterium tuberculosis

Correct answer: B

Rationale: The Mantoux test, also known as the tuberculin skin test, is the most appropriate and accurate test to identify exposure to TB. This test involves injecting a small amount of PPD tuberculin under the top layer of the skin, and a positive reaction indicates exposure to the TB bacteria. Choice A, a chest x-ray, is useful for detecting active TB disease but not exposure. Choice C, a breath sounds examination, is not a specific test for TB exposure. Choice D, a sputum culture for Mycobacterium tuberculosis, is used to diagnose active TB infection rather than exposure.

4. Metformin (Glucophage) is administered to clients with type II diabetes mellitus. Metformin is an example of:

• A. an antihyperglycemic agent.
• B. a hypoglycemic agent.
• C. an insulin analogue.
• D. a pancreatic alpha cell stimulant

Correct answer: A

Rationale: Metformin is classified as an antihyperglycemic agent because it works by reducing hepatic glucose output and decreasing glucose absorption from the gut, thereby preventing hyperglycemia. Choice B, a hypoglycemic agent, is incorrect as hypoglycemic agents stimulate insulin production, which is not the mechanism of action of metformin. Choice C, an insulin analogue, is incorrect as metformin is not a type of insulin but a distinct medication. Choice D, a pancreatic alpha cell stimulant, is incorrect as metformin does not stimulate any pancreatic cells, but rather acts on the liver and gut to lower blood sugar levels.

5. Which of the following should be included in a diet rich in iron?

• A. peaches, eggs, beef
• B. cereals, kale, cheese
• C. red beans, enriched breads, squash
• D. legumes, green beans, eggs

Correct answer: A

Rationale: The correct answer is peaches, eggs, beef. These are good sources of heme iron, which is more easily absorbed by the body compared to nonheme iron. Heme iron is mainly found in animal-based foods like meat, poultry, and fish. Peaches, eggs, and beef are rich in iron and can help prevent iron deficiency anemia. Choices B, C, and D are incorrect because they do not include significant sources of heme iron. Cereals, kale, cheese, red beans, enriched breads, squash, legumes, and green beans are sources of nonheme iron, which is not as efficiently absorbed by the body as heme iron. It is important to include heme iron sources in the diet for optimal iron absorption.

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