Nursing Elites

1. Which of the following medications is commonly prescribed for hypertension?

• A. Atenolol
• B. Aspirin
• C. Ibuprofen
• D. Metformin

Correct answer: A

Rationale: The correct answer is Atenolol. Atenolol is a beta-blocker commonly prescribed to manage hypertension due to its ability to reduce the heart rate and lower blood pressure. Options B, C, and D are incorrect because aspirin, ibuprofen, and metformin are not typically used as first-line treatments for hypertension. Aspirin is more commonly used for its antiplatelet effects, ibuprofen is a nonsteroidal anti-inflammatory drug, and metformin is primarily used for managing diabetes.

2. What is the most important content for the nurse to include in discharge teaching for a 51-year-old truck driver who smokes two packs of cigarettes a day, is 30 pounds overweight, and has been diagnosed with a gastric ulcer?

• A. Information about smoking cessation.
• B. Diet instructions for a low-residue diet.
• C. Instructions on a weight-loss program.
• D. The importance of increasing milk in the diet.

Correct answer: A

Rationale: The correct answer is A: Information about smoking cessation. Smoking is a significant risk factor for ulcer formation. It is crucial for the nurse to include smoking cessation information in the discharge teaching to help manage the gastric ulcer and prevent further complications. Choices B, C, and D are less relevant in this scenario. While diet modifications may be beneficial, addressing smoking cessation takes precedence due to its direct correlation with ulcer development.

3. A client with autosomal dominant polycystic kidney disease (ADPKD) asks, “Will my children develop this disease?” How should the nurse respond?

• A. No genetic link is known, so your children are not at increased risk.
• B. Your sons will develop this disease because it has a sex-linked gene.
• C. Only if both you and your spouse are carriers of this disease.
• D. Each of your children has a 50% risk of having ADPKD.

Correct answer: D

Rationale: Children whose parent has the autosomal dominant form of PKD have a 50% chance of inheriting the gene that causes the disease. ADPKD is transmitted as an autosomal dominant trait and therefore is not gender-specific. Both parents do not need to have this disorder. Choice A is incorrect because ADPKD has a known genetic link and a definitive mode of inheritance. Choice B is incorrect as ADPKD is not sex-linked but autosomal dominant. Choice C is incorrect because ADPKD follows an autosomal dominant inheritance pattern and does not require both parents to be carriers for the child to inherit the disease.

4. The client is receiving teletherapy radiation for a malignant tumor. Which instruction regarding skin care of the portal site should the nurse provide?

• A. Protect the skin of the radiation portal site from sunlight exposure
• B. Apply moisturizing lotions daily to the radiation portal site
• C. Avoid washing the skin inside the radiation portal site
• D. Remove the ink marks of the portal after each radiation treatment

Correct answer: A

Rationale: Protecting the skin from sunlight exposure is crucial to prevent radiation burns and additional skin damage at the treatment site. Sun exposure can exacerbate skin reactions caused by radiation therapy. Applying moisturizing lotions daily may introduce foreign substances or irritants to the treated area, leading to potential complications. Washing the skin inside the radiation portal site is important for maintaining cleanliness and preventing infections. Removing the ink marks after each treatment is unnecessary and may cause unnecessary skin irritation and trauma.

5. A nurse reviews the laboratory findings of a client with a urinary tract infection. The laboratory report notes a “shift to the left” in the client’s white blood cell count. Which action should the nurse take?

• A. Request that the laboratory perform a differential analysis on the white blood cells.
• B. Notify the provider and start an intravenous line for parenteral antibiotics.
• C. Collaborate with the unlicensed assistive personnel (UAP) to strain the client’s urine for renal calculi.
• D. Assess the client for a potential allergic reaction and anaphylactic shock.

Correct answer: B

Rationale: A “shift to the left” in a white blood cell count indicates an increase in band cells, which is typically associated with urosepsis. In this scenario, the nurse should notify the provider and initiate IV antibiotics as a left shift is often seen in severe infections like urosepsis. Requesting a differential analysis on white blood cells would not be the immediate action needed in response to a left shift. Collaborating to strain urine for renal calculi is unrelated to the situation of a left shift in white blood cells due to urosepsis. Assessing for allergic reactions and anaphylactic shock is not the priority as a left shift is not indicative of an allergic response; it is associated with an increase in band cells, not eosinophils.

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