Nursing Elites

1. Which condition is characterized by a progressive loss of muscle strength due to an autoimmune attack on acetylcholine receptors?

• A. Myasthenia gravis
• B. Multiple sclerosis
• C. Amyotrophic lateral sclerosis
• D. Guillain-Barré syndrome

Correct answer: A

Rationale: The correct answer is A: Myasthenia gravis. Myasthenia gravis is characterized by muscle weakness caused by autoimmune attack on acetylcholine receptors at the neuromuscular junction. This results in impaired communication between nerves and muscles. Choice B, Multiple sclerosis, is a condition where the immune system attacks the protective myelin sheath covering the nerves in the central nervous system, leading to communication issues between the brain and the rest of the body. Choice C, Amyotrophic lateral sclerosis, is a progressive neurodegenerative disease affecting motor neurons in the brain and spinal cord, not involving acetylcholine receptors. Choice D, Guillain-Barré syndrome, is an acute condition where the immune system attacks the peripheral nerves, causing muscle weakness and paralysis, but it does not target acetylcholine receptors.

2. A client who had a right total shoulder replacement is being prepared for discharge. What should the nurse emphasize to the client to prevent complications?

• A. Avoid lifting objects with the right arm until cleared by the surgeon.
• B. Perform shoulder exercises to regain strength.
• C. Use a sling at all times, even during sleep.
• D. Apply heat to the shoulder to reduce stiffness.

Correct answer: A

Rationale: The correct answer is to avoid lifting objects with the right arm until cleared by the surgeon. After a total shoulder replacement, it is essential to protect the new joint to prevent dislocation or injury. Lifting heavy objects prematurely can lead to complications. While performing shoulder exercises is important for strength, they should be done as per the healthcare provider's instructions to avoid strain on the new joint. Using a sling at all times, as in choice C, is not necessary once the client has regained enough strength and mobility. Applying heat, as in choice D, may not be recommended post-surgery; cold therapy is often preferred to reduce swelling and pain.

3. A client who is post-operative from a carotid endarterectomy is experiencing difficulty swallowing. What is the nurse's priority action?

• A. Administer a prescribed antiemetic.
• B. Assess the client’s airway and respiratory status.
• C. Elevate the head of the bed.
• D. Encourage the client to take small sips of water.

Correct answer: B

Rationale: The correct answer is to assess the client’s airway and respiratory status (Choice B). Difficulty swallowing after carotid endarterectomy could indicate swelling or nerve damage affecting swallowing, which may compromise the airway. Assessing the airway and respiratory status is crucial to ensure the client's ability to breathe. Administering an antiemetic (Choice A) is not the priority as the primary concern is airway patency. Elevating the head of the bed (Choice C) can help with swallowing difficulties but does not address the immediate risk to the airway. Encouraging the client to take small sips of water (Choice D) is contraindicated if there is a risk of compromised airway due to swallowing difficulties.

4. A client confides to the nurse that the client has been substituting herbal supplements for high blood pressure instead of the prescribed medication. How should the nurse respond first?

• A. Ask the client's reason for choosing to take herbs instead of prescribed medication
• B. Reinforce that the healthcare provider prescribed the medication for a reason
• C. Have the client use their own words to describe complications of high blood pressure
• D. Point out the risks of not taking the prescribed medication rather than herbal supplements

Correct answer: A

Rationale: The correct answer is to ask the client's reason for choosing to take herbs instead of prescribed medication. Understanding the client's rationale for using herbal supplements allows the nurse to explore any misconceptions and provide education on the importance of the prescribed medication. Choice B is incorrect because simply reinforcing the prescription does not address the client's concerns or reasons for using herbal supplements. Choice C does not directly address the immediate concern of the client substituting medication with herbal supplements. Choice D focuses on the risks of not taking the prescribed medication rather than herbal supplements, which is not the most appropriate initial response.

5. A client with peripheral neuropathy due to cirrhosis is at risk for injury. What should the nurse do?

• A. Protect the client's feet from injury
• B. Apply a heating pad to the affected area
• C. Keep the client's feet elevated
• D. Assess the feet and legs for jaundice

Correct answer: A

Rationale: Protecting the client's feet from injury is critical as peripheral neuropathy can lead to decreased sensation and increased risk of trauma. This measure helps prevent wounds, ulcers, and other complications. Applying a heating pad (Choice B) can worsen symptoms and cause burns due to decreased sensation. Keeping the client's feet elevated (Choice C) may help reduce swelling but does not directly address the risk of injury. Assessing for jaundice (Choice D) is important in cirrhosis but is not directly related to the client's risk of injury due to peripheral neuropathy.

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