Nursing Elites

1. The nurse is caring for a client with a malignancy. The classification of the primary tumor is Tis. The nurse should plan care for a tumor:

• A. That can be assessed
• B. That is in situ
• C. With increasing lymph node involvement
• D. With distant metastasis

Correct answer: B

Rationale: The correct answer is B: 'That is in situ.' Cancer in situ means that the cancer is still localized to the primary site. Cancer is graded in terms of tumor, grade, node involvement, and metastasis. Answer A is incorrect because Tis indicates a tumor that is in situ and can be assessed. Answer C is incorrect because T indicates tumor, not node involvement. Answer D is incorrect because a tumor that is in situ is not metastasized.

2. When questioning an elder about suspected abuse, how should the nurse keep the questions?

• A. Nonjudgmental.
• B. Probing.
• C. Confrontational.
• D. Indirect.

Correct answer: A

Rationale: When questioning an elder about suspected abuse, the nurse should keep the questions nonjudgmental. This approach helps the elder feel safe and more willing to share information. Probing questions might be perceived as invasive, confrontational questions can lead to defensiveness and denial, and indirect questions may not elicit the necessary information, resulting in confusion or misinterpretation.

3. The physician has ordered a culture for the client with suspected gonorrhea. The nurse should obtain which type of culture?

• A. Blood
• B. Nasopharyngeal secretions
• C. Stool
• D. Genital secretions

Correct answer: D

Rationale: A culture for gonorrhea is taken from the genital secretions as gonorrhea primarily affects the genital area. The culture is incubated in a warm environment to promote the growth of Neisseria gonorrhoeae, the bacterium causing gonorrhea. Genital secretions provide a direct sample from the site of infection, increasing the accuracy of diagnosis. Choices A, B, and C are incorrect as they are not suitable specimens for diagnosing gonorrhea. Blood cultures are used to detect bloodstream infections, nasopharyngeal secretions are collected for respiratory infections, and stool cultures are done to identify gastrointestinal infections, none of which are related to gonorrhea.

4. A client has been taking alprazolam (Xanax) for four years to manage anxiety. The client reports taking 0.5 mg four times a day. Which statement indicates that the client understands the nurse's teaching about discontinuing the medication?

• A. "I can drink alcohol now that I am decreasing my Xanax."?
• B. "I should not take another Xanax pill. Here is what is left of my last prescription."?
• C. "I should take three pills per day next week, then two pills for one week, then one pill for one week."?
• D. "I can expect to be sleepy for several days after stopping the medicine."?

Correct answer: C

Rationale: The correct answer is that the client should take three pills per day next week, then two pills for one week, and then one pill for one week. This statement indicates a gradual tapering schedule, which is crucial when discontinuing alprazolam (Xanax) to prevent withdrawal symptoms. Choice A is incorrect because alcohol should be avoided while tapering off benzodiazepines due to the increased risk of respiratory depression. Choice B is incorrect because abruptly stopping alprazolam can lead to withdrawal symptoms. Choice D is incorrect because while drowsiness can be a side effect of alprazolam, it is not the primary concern when discontinuing the medication; preventing withdrawal symptoms is the priority.

5. Why is the intravenous route potentially the most dangerous route of drug administration?

• A. IV infiltration may occur.
• B. it allows for rapid administration of a drug.
• C. rapid administration of a drug can lead to toxicity
• D. it is the most commonly used route in hospitals.

Correct answer: C

Rationale: The correct answer is C: rapid administration of a drug can lead to toxicity. When a drug is administered intravenously, it has 100% bioavailability, entering the bloodstream immediately and increasing the risk of toxicity if not carefully monitored. While IV infiltration (choice A) can cause tissue damage, it is not typically life-threatening. Choice B is incorrect as the speed of administration is not the primary reason for the danger; it is the immediate and full dose reaching the bloodstream. Choice D is incorrect as the popularity of the route does not inherently make it more dangerous.

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