Nursing Elites

1. Which NSAID is comparable to morphine in efficacy?

• A. Feldene
• B. Stodal
• C. Toradol
• D. Elavil

Correct answer: C

Rationale: The correct answer is Toradol. Toradol is the first injectable NSAID that has been found to be comparable to morphine in terms of efficacy. Feldene (choice A) is not known for being comparable to morphine in efficacy. Stodal (choice B) is a homeopathic cough syrup and not an NSAID. Elavil (choice D) is a tricyclic antidepressant and not an NSAID, so it is not comparable to morphine in efficacy. Therefore, Toradol is the most appropriate choice as it matches the description provided in the question.

2. An LPN is caring for a primarily bedridden client. Which finding should be of least concern?

• A. swollen feet
• B. brown discoloration above the ankles
• C. leg pain
• D. capillary refill time of 3 seconds on the big toe

Correct answer: D

Rationale: The correct answer is the capillary refill time of 3 seconds on the big toe. A capillary refill time longer than three seconds may indicate inadequate blood flow. Swollen feet, brown discoloration above the ankles, and leg pain are all signs of venous insufficiency to the lower extremities. These findings can suggest circulation issues and require further assessment and intervention. Therefore, they should be of more concern compared to the capillary refill time of 3 seconds on the big toe, which is within the normal range of 2-3 seconds.

3. A primigravida begins labor when her family is unavailable and she is alone. She is very upset that her family is not with her. Which approach can the nurse take to meet the client's needs at this time?

• A. asking whether another individual wants to be her support person
• B. assuring her that a nursing staff member will be with her at all times
• C. telling her you will try to locate her family
• D. reinforcing the woman's confidence in her own abilities to cope and maintain a sense of control

Correct answer: A

Rationale: In this situation, the best approach for the nurse is to ask whether another individual wants to be the client's support person. This empowers the client to choose someone to be with her until her family can join her, providing the needed support and comfort. Assuring her that a nursing staff member will be with her at all times (Choice B) may not fully address her emotional needs for familiar support. Telling her you will try to locate her family (Choice C) may not be feasible in the immediate situation and may not provide immediate emotional support. While reinforcing the woman's confidence in her own abilities (Choice D) is important, it may not fully address her current need for emotional support and presence of a companion.

4. Which situation is an example of the use of evidence-based practice in the delivery of client care?

• A. Encouraging a client who has had a stroke to consume thickened liquids and soft foods
• B. Picking up a dislodged radiation implant with long-handled forceps and placing it in a lead container to minimize radiation exposure
• C. Pouring 1 to 2 mL of sterile solution that will be used for wound cleansing into a plastic-lined waste receptacle before pouring the solution into a sterile basin
• D. Blowing on a fingerstick site to dry it after cleaning the site with an alcohol swab

Correct answer: C

Rationale: Evidence-based practice is an approach that integrates client preferences, clinical expertise, and the best research evidence to deliver quality care. Pouring sterile solution into a plastic-lined waste receptacle before using it for wound cleansing reflects evidence-based practice by preventing the entrance of harmful bacteria into the wound. Option A is incorrect because encouraging a stroke client to consume thickened liquids and soft foods is appropriate, not thin liquids and foods that pose a choking risk. Option B is incorrect as picking up a radiation implant with long-handled forceps to minimize radiation exposure is a safety measure, not evidence-based practice. Option D is incorrect because blowing on a fingerstick site after cleaning can recontaminate the site, which goes against best practices in infection control.

5. Signs of internal bleeding include all of the following except:

• A. painful or swollen extremities
• B. a tender, rigid abdomen
• C. vomiting bile
• D. bruising

Correct answer: C

Rationale: Vomiting bile is not typically a sign of internal bleeding but is more commonly associated with issues in the gastrointestinal tract. Signs of internal bleeding include painful or swollen extremities, a tender, rigid abdomen, and bruising. Painful or swollen extremities can indicate bleeding from an extremity injury, a tender, rigid abdomen can signal abdominal bleeding, and bruising can result from blood vessel damage. Therefore, the correct answer is 'C: vomiting bile,' as it is not a typical sign of internal bleeding.

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