Nursing Elites

1. The client diagnosed with acute pancreatitis has developed a pseudocyst that ruptures. Which procedure should the nurse anticipate the HCP ordering?

• A. Paracentesis
• B. Chest tube insertion
• C. Lumbar puncture
• D. Biopsy of the pancreas

Correct answer: B

Rationale: The correct answer is B: Chest tube insertion. In the context of a pancreatic pseudocyst rupturing, a chest tube may be needed if the pseudocyst extends into the pleural space, leading to a pleural effusion. Choice A, paracentesis, involves the removal of fluid from the abdominal cavity, not the pleural space. Choice C, lumbar puncture, is a procedure performed to collect cerebrospinal fluid from the spinal canal, not relevant in this scenario. Choice D, biopsy of the pancreas, is not indicated in the immediate management of a ruptured pseudocyst.

2. A true statement about medications is that:

• A. Over-the-counter medications are unlikely to interact with food or nutrients
• B. Prescription medications always have significant interactions with food
• C. Prescription and nonprescription drugs and herbal remedies interact with food
• D. Herbal products are generally safe since they are natural

Correct answer: C

Rationale: The correct answer is C. This statement is true because both prescription and over-the-counter medications, as well as herbal remedies, can interact with food. Choice A is incorrect because over-the-counter medications can also interact with food or nutrients. Choice B is incorrect as not all prescription medications have significant interactions with food. Choice D is incorrect because natural herbal products can also have side effects and interactions with other substances.

3. The client is complaining of painful swallowing secondary to mouth ulcers. Which statement by the client indicates appropriate management?

• A. “I will brush my teeth with a soft-bristle toothbrush.”
• B. “I will rinse my mouth with Listerine mouthwash.”
• C. “I will swish my antifungal solution and then swallow.”
• D. “I will avoid spicy foods, tobacco, and alcohol.”

Correct answer: D

Rationale: The correct answer is D. Avoiding irritants like spicy foods, tobacco, and alcohol is crucial in managing mouth ulcers as they can further irritate the ulcers and delay healing. Choices A, B, and C could potentially worsen the condition. Brushing with a soft-bristle toothbrush may cause discomfort, rinsing with Listerine mouthwash can be too harsh on the ulcers, and swallowing antifungal solution is not recommended unless specified by a healthcare provider.

4. Which nursing instruction should the nurse discuss with the client who is receiving glucocorticoids for Addison’s disease?

• A. Discuss the importance of tapering medications when discontinuing medication
• B. Explain that the dose will need to be decreased during times of stress or infection
• C. Instruct the client to take medication on an empty stomach with a glass of water
• D. Encourage the client to wear a MedicAlert bracelet and carry a card in the wallet

Correct answer: A

Rationale: The correct answer is to discuss the importance of tapering medications when discontinuing medication. Tapering glucocorticoids is crucial to prevent adrenal insufficiency, which can occur if the medication is stopped abruptly. Choice B is incorrect because it focuses on adjustments during stress or infection, not discontinuation. Choice C is unrelated to the management of glucocorticoids. Choice D is important for emergency identification but is not directly related to medication management.

5. A patient with diabetes should be advised to avoid which type of carbohydrate?

• A. Simple carbohydrates
• B. Complex carbohydrates
• C. Fiber-rich carbohydrates
• D. All carbohydrates

Correct answer: A

Rationale: A patient with diabetes should be advised to avoid simple carbohydrates. Simple carbohydrates can cause rapid spikes in blood glucose levels due to their quick absorption, which can be challenging to manage for individuals with diabetes. Complex carbohydrates and fiber-rich carbohydrates are generally better choices for individuals with diabetes as they are absorbed more slowly, leading to more stable blood glucose levels. Avoiding all carbohydrates is not necessary or recommended, as carbohydrates are an essential source of energy and nutrients in a balanced diet.

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