Nursing Elites

1. Which of the following conditions has a severe complication of respiratory failure?

• A. Bell's palsy
• B.
• C. Trigeminal neuralgia
• D. Tetanus

Correct answer: B

Rationale:

2. Distribution of a drug to various tissues depends on the amount of cardiac output to each type of tissue. Which tissue would receive the highest amount of cardiac output and thus the highest amount of a drug?

• A. skin
• B. adipose tissue
• C. skeletal muscle
• D. myocardium

Correct answer: D

Rationale: The correct answer is 'myocardium.' Highly perfused tissues include vital organs like the brain, heart, kidneys, adrenal glands, and liver. The myocardium, being heart muscle, receives the highest amount of cardiac output and thus the highest amount of a drug. Choices A, B, and C are incorrect because the skin and adipose tissue are poorly perfused, while skeletal muscle is less perfused compared to vital organs like the myocardium.

3. A client with dumping syndrome should ___________ while a client with GERD should ___________.

• A. lie down 1 hour after meals; sit up at least 30 minutes after meals
• B. sit up 1 hour after meals; lie flat 30 minutes after meals
• C. sit up after meals; sit up after meals
• D. lie down after meals; lie down after meals

Correct answer: A

Rationale: Clients with dumping syndrome should lie down after eating to decrease the symptoms of dumping syndrome, which include rapid gastric emptying leading to various gastrointestinal symptoms. On the other hand, clients with GERD should sit up at least 30 minutes after meals to prevent the backflow of stomach acid into the esophagus. This position helps reduce symptoms by allowing gravity to keep the stomach contents in place, minimizing the chances of reflux. Therefore, the correct answer is to lie down 1 hour after eating for dumping syndrome and to sit up at least 30 minutes after eating for GERD. Choices B, C, and D are incorrect because they do not accurately reflect the appropriate positioning for each condition.

4. A 20-year-old male client had a diving accident with subsequent paraplegia. He says to the nurse, "No woman will ever want to marry me now."? Which of the following responses by the nurse is most therapeutic?

• A. "Don't worry. Maybe you'll meet a paraplegic woman."?
• B. "There is someone for everyone in this world."?
• C. "You are still an attractive man, even though you can't walk."?
• D. "Tell me more about your feelings on this issue."?

Correct answer: D

Rationale: The correct response is 'Tell me more about your feelings on this issue.' This answer is the most therapeutic as it encourages the client to express his emotions and concerns, fostering a supportive and open dialogue between the client and the nurse. Option A may come across as dismissive and does not directly address the client's emotional state. Option B, while positive, oversimplifies the client's complex feelings. Option C focuses only on physical appearance, missing the opportunity to delve deeper into the client's emotional well-being. Therefore, the most therapeutic response is to encourage further discussion about the client's feelings.

5. All of the following interventions should be performed when fetal heart monitoring indicates fetal distress except:

• A. Increase maternal fluids.
• B. Administer oxygen.
• C. Decrease maternal fluids.
• D. Turn the mother.

Correct answer: C

Rationale: When fetal heart monitoring indicates fetal distress, interventions are aimed at improving oxygenation to the fetus. Increasing maternal fluids helps improve placental perfusion and oxygen delivery to the fetus. Administering oxygen also aids in increasing oxygen supply to the fetus. Turning the mother can help relieve pressure on the vena cava, optimizing blood flow to the placenta. Therefore, decreasing maternal fluids would not be performed as it can further compromise placental perfusion and fetal oxygenation, making it the exception. Decreasing maternal fluids could potentially exacerbate fetal distress by reducing oxygen delivery and nutrient supply to the fetus, which is contrary to the goal of managing fetal distress.

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