Nursing Elites

1. Tricyclics (Antidepressants) can sometimes have which of the following adverse effects on patients diagnosed with depression?

• A. Shortness of breath
• B. Fainting
• C. Large intestine ulcers
• D. Distal muscular weakness

Correct answer: B

Rationale: The correct answer is 'Fainting.' Tricyclic antidepressants can cause fainting and hypotension as adverse effects. Shortness of breath (Choice A) is not a common side effect of tricyclics. Large intestine ulcers (Choice C) are not typically associated with tricyclic antidepressants. Distal muscular weakness (Choice D) is not a common adverse effect of tricyclics but is commonly associated with other medications.

2. The client with cirrhosis of the liver is receiving Lactulose. The nurse is aware that the rationale for the order for Lactulose is:

• A. To lower the blood glucose level
• B. To lower the uric acid level
• C. To lower the ammonia level
• D. To lower the creatinine level

Correct answer: C

Rationale: Lactulose is administered to the client with cirrhosis to lower ammonia levels, as it works by acidifying the colon, trapping ammonia for elimination in the stool. Choices A, B, and D are incorrect because Lactulose does not have an effect on blood glucose, uric acid, or creatinine levels. Therefore, the correct answer is to lower the ammonia level.

3. Which of the following attitudes is essential in a nurse who assists clients during crises?

• A. viewing crisis intervention as the first step in solving bigger problems
• B. wanting to help clients solve all problems identified
• C. taking an active role in guiding the process
• D. feeling that work requires identification with all of a client's problems

Correct answer: A

Rationale: Viewing crisis intervention as the first step in solving bigger problems is essential in a nurse who assists clients during crises. This approach focuses on addressing the immediate crisis first, which can potentially prevent the escalation of bigger problems. Wanting to help clients solve all problems identified (Choice B) may not be feasible or necessary during a crisis situation where immediate intervention is crucial. Taking an active role in guiding the process (Choice C) is important, but the primary focus should be on crisis intervention. Feeling that work requires identification with all of a client's problems (Choice D) may lead to a lack of focus on the immediate crisis at hand.

4. The nurse is making assignments for the day. Which client should be assigned to the nursing assistant?

• A. A client with Alzheimer's disease
• B. A client with pneumonia
• C. A client with appendicitis
• D. A client with thrombophlebitis

Correct answer: A

Rationale: The client with Alzheimer's disease is the most stable among the clients listed and can be appropriately assigned to the nursing assistant. Nursing assistants are capable of providing care such as feeding and assisting with activities of daily living for individuals with Alzheimer's disease. Clients with pneumonia, appendicitis, and thrombophlebitis are less stable and necessitate the expertise of a registered nurse for accurate assessment and interventions. Therefore, the nursing assistant can effectively care for the client with Alzheimer's disease while ensuring that the other clients receive the necessary level of care from a registered nurse.

5. Fat emulsions are frequently administered as a part of total parenteral nutrition. Which statement is true regarding fat emulsions?

• A. They have a high energy-to-fluid-volume ratio.
• B. Even though hypertonic, they are well tolerated.
• C. They are a basic solution due to the addition of sodium hydroxide (NaOH).
• D. The pH is alkaline, making them compatible with most medications.

Correct answer: A

Rationale: The correct statement is that fat emulsions have a high energy-to-fluid-volume ratio. Fat emulsions are formulated in 10%, 20%, and 30% solutions and supply 1.1, 2, and 3 kilocalories, respectively, for each milliliter. In comparison, a milliliter of 5% dextrose only supplies 0.17 kilocalories. Choices B, C, and D are incorrect. Choice B is false because fat emulsions are essentially pH neutral and isotonic, not hypertonic. Choice C is incorrect because fat emulsions are not basic solutions; they are essentially pH neutral. Choice D is incorrect as fat emulsions are not alkaline; they are pH neutral, making them compatible with most medications.

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