Nursing Elites

1. The patient with bipolar disorder is being treated with lithium and has a new prescription for captopril for hypertension. The combination of these two drugs makes which assessment particularly important?

• A. Potassium level
• B. Lithium level
• C. Creatinine level
• D. Blood pressure

Correct answer: B

Rationale: When captopril, an ACE inhibitor, is combined with lithium, it can lead to lithium accumulation. Therefore, monitoring lithium levels is crucial to prevent toxicity. While ACE inhibitors like captopril can cause hyperkalemia, renal insufficiency, and hypotension, the risk of these effects is not increased by the combination of lithium and captopril.

2. During a vaso-occlusive crisis in sickle cell anemia, what action is crucial for a nurse to take?

• A. Administer meperidine for pain.
• B. Apply cold compresses to the child's joints.
• C. Limit the child's fluid intake.
• D. Maintain bed rest for the child.

Correct answer: D

Rationale: During a vaso-occlusive crisis in sickle cell anemia, maintaining bed rest is crucial to reduce oxygen consumption and alleviate pain. Movement can worsen the crisis by increasing sickling of red blood cells, leading to further tissue damage and pain. Bed rest helps to improve blood flow, reduce pain, and promote healing. Administering meperidine for pain (Choice A) is not recommended due to the risk of normeperidine accumulation and potential neurotoxicity. Applying cold compresses (Choice B) may cause vasoconstriction, worsening the vaso-occlusive crisis. Limiting fluid intake (Choice C) is not appropriate as adequate hydration is essential to prevent dehydration and maintain blood flow.

3. A patient is 1 hour postoperative following an open reduction internal fixation of the left tibia. Which of the following actions should the nurse take?

• A. Assess neurovascular status of the extremities every 4 hours
• B. Monitor the patient's pain level every 8 hours
• C. Assist the patient to the bathroom every 2 hours
• D. Keep the patient's left leg elevated on two pillows

Correct answer: A

Rationale: The correct action for the nurse to take 1 hour postoperative following an open reduction internal fixation of the left tibia is to assess neurovascular status of the extremities every 4 hours. This frequent assessment is crucial to monitor for any signs of complications such as impaired circulation or nerve damage. Monitoring every 4 hours allows for early detection of any issues, enabling timely intervention and prevention of potential complications. Monitoring the patient's pain level every 8 hours (choice B) is not as immediate or essential for postoperative care. Assisting the patient to the bathroom every 2 hours (choice C) may not be necessary if the patient is not ambulatory yet. Keeping the patient's left leg elevated on two pillows (choice D) can be beneficial but is not the priority in the immediate postoperative period compared to assessing neurovascular status.

4. Which statement fosters cultural competence?

• A. Treat everyone the same regardless of their culture
• B. Provide an outline of your beliefs as a starting point
• C. Acknowledge and respond to influences of cultural beliefs in the intervention plan
• D. Ask the family to outline how their beliefs will influence therapy

Correct answer: C

Rationale: Cultural competence involves recognizing and considering the impact of cultural beliefs on individuals. By acknowledging and responding to these cultural influences in the intervention plan, professionals can tailor their approach effectively and respectfully. This approach helps build trust, enhances communication, and improves outcomes in culturally diverse settings.

5. A nurse is teaching a parent of a child who has asthma. Which of the following instructions should the nurse include?

• A. Use a peak flow meter daily.
• B. Administer the medication with meals.
• C. Provide a low-carbohydrate diet.
• D. Limit exposure to cold air.

Correct answer: A

Rationale: The nurse should instruct the parent to use a peak flow meter daily to monitor the child�s respiratory status and detect early signs of an asthma attack.

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