Nursing Elites

1. When a staff member is observed not following the plan of care for a client with an antisocial personality disorder, what should the nurse do?

• A. confront the staff member immediately and say, "You know that is not the treatment plan."?
• B. write an incident report to create a paper trail of the staff member's failure to follow the planned program.
• C. ask the staff member to talk in private, and reinforce how antisocial clients try to divide staff.
• D. bring up the incident during the weekly conference so that this staff member is not assigned to work with antisocial persons again.

Correct answer: C

Rationale: When a staff member is observed not following the plan of care for a client with an antisocial personality disorder, it is crucial to address the issue promptly and effectively. Confronting the staff member immediately in front of the client may worsen the situation by enhancing the division of staff and compromising client care. Writing an incident report, although important for documentation, may not address the immediate need to correct the behavior. Bringing up the incident during a weekly conference may not be the most effective approach for immediate resolution. Asking the staff member to talk in private and reinforcing how antisocial clients try to divide staff is the best option. This approach allows for a constructive conversation to address the issue, provide education, and help the staff member develop skills to work effectively with this client population.

2. The client is receiving heparin for thrombophlebitis of the left lower extremity. Which of the following drugs reverses the effects of heparin?

• A. Cyanocobalamin
• B. Protamine sulfate
• C. Streptokinase
• D. Sodium warfarin

Correct answer: B

Rationale: The correct answer is Protamine sulfate. Protamine sulfate is the antidote for heparin, as it reverses its effects. Cyanocobalamin is a form of Vitamin B12 and is not used to reverse heparin effects. Streptokinase is a thrombolytic agent that is used to dissolve blood clots, not to reverse heparin effects. Sodium warfarin is an anticoagulant, but it is not the antidote for heparin. Therefore, answers A, C, and D are incorrect as they do not reverse the effects of heparin.

3. The child with seizure disorder is being treated with Dilantin (phenytoin). Which of the following statements by the patient's mother indicates to the nurse that the patient is experiencing a side effect of Dilantin therapy?

• A. "She is very irritable lately."?
• B. "She sleeps quite a bit of the time."?
• C. "Her gums look too big for her teeth."?
• D. "She has gained about 10 pounds in the last 6 months."?

Correct answer: C

Rationale: The correct answer is '"Her gums look too big for her teeth."?' Hyperplasia of the gums is a known side effect associated with Dilantin therapy. Option A, '"She is very irritable lately,"?' is not a typical side effect of Dilantin. Option B, '"She sleeps quite a bit of the time,"?' is a common side effect of Dilantin but not specific to gum hyperplasia. Option D, '"She has gained about 10 pounds in the last 6 months,"?' is not typically associated with Dilantin therapy and is unrelated to the question.

4. Hormonal agents are used to treat some cancers. An example is:

• A. thyroxine to treat thyroid cancer.
• B. ACTH to treat adrenal carcinoma.
• C. estrogen antagonists to treat breast cancer.
• D. glucagon to treat pancreatic carcinoma.

Correct answer: C

Rationale: Estrogen antagonists are commonly used to treat estrogen hormone-dependent cancers such as breast carcinoma. One well-known estrogen antagonist used in breast cancer therapy is Tamoxifen (Nolvadex). This drug, in combination with surgery and other chemotherapeutic drugs, reduces breast cancer recurrence by 30%. Estrogen antagonists can also be administered to prevent breast cancer in women who have a strong family history. Thyroxine is a thyroid hormone used to treat hypothyroidism, not thyroid cancer. ACTH is an anterior pituitary hormone that stimulates the adrenal glands to release glucocorticoids; it does not treat adrenal cancer. Glucagon is a pancreatic alpha cell hormone that stimulates glycogenolysis and gluconeogenesis; it does not treat pancreatic cancer.

5. In which age group does the highest incidence of child abuse occur?

• A. Birth-3 years old
• B. 4-6 years old
• C. 6-10 years old
• D. More than 10 years old

Correct answer: A

Rationale: The correct answer is 'Birth-3 years old.' Children between birth and 3 years of age have the highest rates of victimization (at 16 per 1,000 children). This age group is most vulnerable due to their dependency and inability to report or protect themselves effectively. Child abuse can occur at any age, but statistics show that infants and toddlers are at the highest risk due to their developmental stage and reliance on caregivers. Choices B, C, and D are incorrect because while child abuse can happen at any age, the prevalence is highest among children in the 0-3 age group.

Similar Questions