Nursing Elites

1. Which of the following neurological disorders is characterized by writhing, twisting movements of the face and limbs?

• A. epilepsy
• B. Parkinson's
• C. multiple sclerosis
• D. Huntington's chorea

Correct answer: D

Rationale: Huntington's chorea is characterized by writhing, twisting movements of the face and limbs, known as chorea. This disorder is caused by a genetic mutation affecting specific brain cells. Epilepsy presents with seizures, Parkinson's with tremors and rigidity, and multiple sclerosis with central nervous system issues. The specific description of writhing and twisting movements aligns with Huntington's chorea, making it the correct answer. Choices A, B, and C are incorrect as they describe different neurological disorders with distinct symptoms that do not match the writhing, twisting movements characteristic of Huntington's chorea.

2. When administering NSAID adjunctive therapy to an elderly client with cancer, the nurse must monitor:

• A. BUN and creatinine.
• B. creatinine and calcium.
• C. Hgb and Hct.
• D. BUN and CFT.

Correct answer: A

Rationale: When an elderly client with cancer is receiving NSAID therapy, monitoring BUN (blood urea nitrogen) and creatinine levels is crucial. NSAIDs can cause renal toxicity, especially in the elderly. BUN and creatinine levels help assess renal function and detect early signs of renal impairment. Monitoring creatinine alone (Choice B) is not sufficient as BUN provides complementary information about renal function. Monitoring hemoglobin (Hgb) and hematocrit (Hct) (Choice C) is important for assessing anemia but not specific to NSAID therapy in the elderly. CFT (Choice D) is not a standard abbreviation in this context, and monitoring coagulation function is not directly related to NSAID therapy in this scenario.

3. What is a common side effect of Rifampin concerning the client's contact lenses?

• A. The client's urine might turn blue.
• B. The client remains infectious to others for 48 hours.
• C. The client's contact lenses might be stained orange.
• D. The client's skin might take on a crimson glow.

Correct answer: C

Rationale: The correct answer is that the client's contact lenses might be stained orange. Rifampin has the unusual effect of turning body fluids an orange color. Soft contact lenses might become permanently stained, making this an important side effect for the client to be aware of. Choices A, B, and D are incorrect. There is no documented effect of Rifampin causing the client's urine to turn blue, the client remaining infectious for 48 hours, or the client's skin taking on a crimson glow.

4. A nurse calls a health care provider to question a prescription written for a higher-than-normal dosage of morphine sulfate. The health care provider changes the prescription to a dosage within the normal range, and the nurse documents the new telephone prescription in accordance with the agency's guidelines in the client's record. Which other statement does the nurse document in the nursing notes?

• A. The health care provider made a mistake in the written prescription for morphine sulfate.
• B. An inaccurate dosage of morphine sulfate was prescribed and the health care provider was informed.
• C. The health care provider was contacted to correct a mistake in the dosage of morphine sulfate.
• D. The health care provider was contacted to clarify the prescription for morphine sulfate

Correct answer: D

Rationale: The nurse needs to document a factual, descriptive, and objective statement that does not include words indicating that an individual made a mistake or performed an incorrect action or procedure. If a health care provider's prescription must be questioned, the nurse should record that clarification regarding the prescription was sought. Therefore, the correct statement to document is that the health care provider was contacted to clarify the prescription for morphine sulfate. Choices A, B, and C imply errors or mistakes on the part of the health care provider, which is not the focus of the documentation in this scenario.

5. The LPN is assisting the client with an NG tube with activities of daily living. Which of these statements would indicate a need for teaching reinforcement?

• A. "Since I'm not eating or drinking by mouth, I do not need to brush my teeth as often."?
• B. "I should remain sitting up at a 45-degree angle or higher for 30 minutes after a feeding."?
• C. "I can clean around the tube with water and mild soap."?
• D. "I should avoid using Vaseline around the nostril and tube."?

Correct answer: A

Rationale: The correct answer is, "Since I'm not eating or drinking by mouth, I do not need to brush my teeth as often."? This statement indicates a need for teaching reinforcement because even when an NG tube is in place, the client should still brush their teeth twice daily. Good oral hygiene is essential to reduce the risk of introducing bacteria that may cause an infection. Choice B is incorrect because remaining sitting up at a 45-degree angle or higher for 30 minutes after a feeding is a correct statement regarding NG tube care, promoting proper digestion and reducing the risk of aspiration. Choice C is also incorrect because cleaning around the tube with water and mild soap is an appropriate practice to maintain cleanliness and prevent infection. Choice D is incorrect because advising to avoid using Vaseline around the nostril and tube is a proper instruction to prevent skin breakdown, occlusion of the tube, and potential aspiration of Vaseline into the lungs.

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