Nursing Elites

1. Which of the following individuals is at the highest risk for suicide?

• A. 76-year-old widow with chronic renal failure
• B. 19-year-old with new SSRI therapy
• C. 28-year-old post-partum crying weekly
• D. 50-year-old client with obsessive-compulsive disorder (OCD) and depression

Correct answer: A

Rationale: The correct answer is the 76-year-old widow with chronic renal failure. Elderly individuals with chronic diseases, especially men, are at very high risk for suicide. The other choices, although they may be vulnerable populations, do not carry as high a risk for suicide. The 19-year-old with new SSRI therapy may actually have a lower risk as they are receiving treatment. The 28-year-old post-partum individual is experiencing a common emotional response after childbirth, which is not necessarily indicative of a high suicide risk. The 50-year-old with OCD and depression is at risk but not as high as elderly individuals with chronic illness.

2. Which physiologic mechanism best describes the function of the sodium-potassium pump?

• A. active transport
• B. diffusion
• C. filtration
• D. osmosis

Correct answer: A

Rationale: Active transport is the correct answer as it accurately describes the process involved in the sodium-potassium pump. The pump utilizes energy to move ions against their concentration gradient, maintaining cellular concentrations. Diffusion (choice B) is a passive process where substances move from an area of higher concentration to lower concentration. Filtration (choice C) involves the movement of solutes based on pressure gradients. Osmosis (choice D) is the movement of water across a semipermeable membrane.

3. Which of the following injuries, if demonstrated by a client entering the Emergency Department, is the highest priority?

• A. open leg fracture
• B. open head injury
• C. stab wound to the chest
• D. traumatic amputation of a thumb

Correct answer: C

Rationale: A stab wound to the chest might result in lung collapse and mediastinal shift that, if untreated, could lead to death. Treatment of an obstructed airway or a chest wound is a higher priority than hemorrhage. The principle of ABC (airway, breathing, and circulation) prioritizes care decisions. In this scenario, the stab wound to the chest poses the highest risk to the client's life as it can lead to severe complications such as lung collapse and mediastinal shift. Addressing this injury promptly is crucial to prevent further harm or potential fatality. Open leg fracture, open head injury, and traumatic amputation of a thumb, while serious, do not pose an immediate life-threatening risk compared to a stab wound to the chest.

4. A client asks a nurse working in a dental office what type of drug the dentist uses to provide anesthesia during the extraction of the client's wisdom teeth. The dentist uses an anesthetic gas, also known as laughing gas. This agent is:

• A. nitrous oxide.
• B. nitrogen.
• C. nitric oxide.
• D. nitrogen dioxide.

Correct answer: A

Rationale: The correct answer is nitrous oxide. Nitrous oxide is commonly known as laughing gas and is used as an anesthetic gas for procedures like dental extractions. It produces analgesia and mild euphoria without loss of consciousness. Nitrogen is a nonmetallic element found in air, while nitric oxide is a vasodilator produced from L-arginine. Nitrogen dioxide is a poisonous gas found in smog and exhaust fumes and is not used for anesthesia.

5. The nurse has just received a change-of-shift report. Which client should the nurse assess first?

• A. A client 2 hours post-lobectomy with 150cc drainage
• B. A client 2 days post-gastrectomy with scant drainage
• C.
• D. A client with a fractured hip in Buck's traction

Correct answer: A

Rationale: The nurse should assess the client 2 hours post-lobectomy with 150cc drainage first because postoperative assessments are crucial during the immediate postoperative period. This client may be at higher risk for complications, such as bleeding or infection, requiring immediate attention. Clients in choices B, C, and D are relatively stable and can be assessed after the immediate postoperative client has been evaluated.

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