Nursing Elites

1. The nurse is caring for a client with epilepsy who is being treated with carbamazepine (Tegretol). Which laboratory value might indicate a serious side effect of this drug?

• A. Uric acid of 5 mg/dL
• B. Hematocrit of 33%
• C. WBC 2,000 per cubic millimeter
• D. Platelets 150,000 per cubic millimeter

Correct answer: C

Rationale: Carbamazepine (Tegretol) can suppress the bone marrow, leading to a decrease in the white blood cell count. A laboratory value of WBC 2,000 per cubic millimeter indicates a serious side effect of the drug. Choices A and D are within normal limits, while choice B is at the lower limit of normal. Therefore, choices A, B, and D are incorrect.

2. The nurse is participating in discharge teaching for the postpartal client. The nurse is aware that an effective means of managing discomfort associated with an episiotomy after discharge is:

• A. Promethazine
• B. Aspirin
• C. Sitz baths
• D. Ice packs

Correct answer: C

Rationale: A sitz bath is an effective method for managing discomfort associated with an episiotomy after discharge. It helps reduce swelling and promotes healing in the perineal area. Ice packs (option D) are typically used immediately after delivery to provide pain relief. Promethazine (option A) and aspirin (option B) are not indicated for managing discomfort associated with an episiotomy. Promethazine is an antihistamine, and aspirin is a nonsteroidal anti-inflammatory drug, both of which are not commonly used for this purpose.

3. When caring for a Native-American family, what does the nurse need to consider?

• A. The family may consist of extended family members beyond parents and children.
• B. Native Americans tend to value their heritage and traditions.
• C. Some Native Americans use herbs and psychologic treatments for illnesses.
• D. Health care practices vary among different tribes and individuals.

Correct answer: C

Rationale: When caring for a Native-American family, it is crucial to acknowledge and respect their cultural beliefs and practices. Choice A, while relevant, is not as specific as understanding the use of herbs and psychologic treatments in Native American healing practices. Choice B, though generally true, does not directly impact the nursing care provided. Choice D, although true, is too broad and does not focus on the specific aspect of treatment practices. Choice C is the most appropriate answer as it highlights the importance of recognizing and incorporating traditional healing methods into the nursing care plan, promoting culturally sensitive and holistic care.

4. The nurse is assessing an elder whom the nurse suspects is being physically abused. The most important question for the nurse to ask is:

• A. "How much money do you keep around the house?"?
• B. "Who provides your physical care?"?
• C. "How close does your nearest relative live?"?
• D. "What form of transportation do you use?"?

Correct answer: B

Rationale: The most important question for the nurse to ask when suspecting elder abuse is 'Who provides your physical care?' This question is crucial as the primary caregiver, who is often the abuser in cases of elder abuse, lives with the client. Research has shown that spouses and adult children are the most common abusers. By inquiring about the provider of physical care, the nurse can assess the potential abuser's proximity to the elder. Choices A, C, and D are less pertinent to identifying the primary caregiver, who is more likely to be the abuser.

5. Support-system enhancement includes all of the following except:

• A. determining the barriers to using support systems.
• B. discussing ways to help others who are concerned.
• C. exploring life problems of the support-team members.
• D. involving spouse, family, and friends in the care and planning.

Correct answer: C

Rationale: Support-system enhancement involves various strategies to strengthen the support system. Determining the barriers to using support systems, discussing ways to help others who are concerned, and involving spouse, family, and friends in the care and planning are all essential aspects of enhancing the support system. However, exploring the life problems of the support-team members is not directly related to enhancing the support system. This approach could potentially invade personal boundaries and may not be necessary for improving the support system, making it the correct answer in this case. Therefore, option C is the correct answer as it does not align with the appropriate methods of support-system enhancement.

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