Nursing Elites

1. What is the primary action a healthcare professional should take when a patient with a suspected myocardial infarction (MI) arrives in the emergency department?

• A. Apply a cold compress to the chest
• B. Administer oxygen and obtain an electrocardiogram (ECG)
• C. Encourage the patient to walk to reduce anxiety
• D. Provide a high-carbohydrate meal

Correct answer: B

Rationale: Administering oxygen and obtaining an ECG are crucial initial steps when managing a suspected myocardial infarction (MI). Oxygen helps improve oxygenation to the heart muscle, while an ECG is essential to diagnose an MI promptly. Applying a cold compress, encouraging the patient to walk, or providing a high-carbohydrate meal are not appropriate actions in the initial management of a suspected MI. Applying a cold compress can delay necessary interventions, encouraging the patient to walk may worsen the condition, and providing a high-carbohydrate meal is irrelevant to the immediate needs of a patient with a suspected MI.

2. You are teaching students about how hyperosmotic agents (osmotic diuretics) are used to treat intracranial pressure. Which of the following is NOT one of the functions of hyperosmotic agents?

• A. Reduces brain metabolism and systemic blood pressure
• B. Reduces cerebral edema
• C. Dehydrates the brain
• D. Draws fluids from extravascular spaces into the plasma

Correct answer: A

Rationale: Hyperosmotic agents primarily work by reducing cerebral edema, dehydrating the brain, and drawing fluids from extravascular spaces into the plasma. However, they do not have a direct effect on reducing brain metabolism or systemic blood pressure. Therefore, the correct answer is A. Choice B is correct as hyperosmotic agents do help in reducing cerebral edema. Choice C is accurate as hyperosmotic agents dehydrate the brain. Choice D is also true as these agents draw fluids from extravascular spaces into the plasma.

3. A client presents to the office with complaints of swelling in the legs, chills, and shortness of breath. During auscultation of the chest, a heart murmur is heard. The client's blood culture reveals a microorganism in the blood. When a microorganism is found in the blood, this condition is called

• A. Bacteremia
• B. Sepsis
• C. Septicemia
• D. Parasitic infection

Correct answer: A

Rationale: When a microorganism is found in the blood, this condition is called bacteremia, which refers to the presence of bacteria in the bloodstream, as indicated by a positive blood culture. If not appropriately treated, bacteremia can progress to septicemia, also known as sepsis. Sepsis is a severe and life-threatening response to an infection, characterized by systemic inflammation and organ dysfunction. Parasitic infections involve pathogens other than bacteria and are not directly related to the scenario described.

4. When caring for a patient with a fresh tracheostomy, what is the nurse’s first priority?

• A. Providing humidified oxygen
• B. Ensuring the tracheostomy ties are secure
• C. Suctioning the tracheostomy tube as needed
• D. Monitoring for signs of infection

Correct answer: B

Rationale: The correct answer is B: Ensuring the tracheostomy ties are secure. This is the nurse's first priority because it is critical to prevent accidental decannulation, which could compromise the patient’s airway. Providing humidified oxygen, suctioning the tracheostomy tube, and monitoring for signs of infection are important aspects of care but ensuring the tracheostomy ties' security takes precedence to maintain the patient's airway.

5. What is the most appropriate nursing action when a patient on anticoagulant therapy develops sudden, severe back pain?

• A. Administer pain medication
• B. Apply a cold compress to the back
• C. Assess for signs of internal bleeding
• D. Reposition the patient for comfort

Correct answer: C

Rationale: When a patient on anticoagulant therapy experiences sudden, severe back pain, the priority nursing action is to assess for signs of internal bleeding. Severe back pain in this context could be indicative of internal bleeding, such as a retroperitoneal bleed, which is a critical condition requiring immediate attention. Administering pain medication or applying a cold compress may mask or delay the identification of a potentially life-threatening situation. Repositioning the patient for comfort is not the priority when internal bleeding needs to be ruled out.

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