Nursing Elites

1. Which patient is at greatest risk for papilledema?

• A. An elderly patient with cataracts and macular degeneration
• B. A male patient with hypothyroidism
• C. A male patient with hyperthyroidism
• D. An adolescent with a closed head injury

Correct answer: D

Rationale: An adolescent with a closed head injury is at the highest risk for papilledema due to increased intracranial pressure. Papilledema is often a consequence of elevated intracranial pressure, which can occur in conditions like head trauma. Choices A, B, and C do not directly correlate with an increased risk of papilledema compared to a closed head injury, which is more likely to lead to elevated intracranial pressure and subsequent papilledema.

2. Your client is adversely affected with fever, night sweats, occult hematuria, tenderness of the spleen, and Osler's nodes. What disorder would you most likely suspect?

• A. Tuberculosis
• B. AIDS/HIV
• C. Pericarditis
• D. Endocarditis

Correct answer: D

Rationale: The client is likely suffering from endocarditis based on the symptoms described. Endocarditis is characterized by fever, night sweats, hematuria, splenomegaly (tenderness of the spleen), and Osler's nodes (painful nodules on the pads of the fingers or toes). While tuberculosis and AIDS/HIV can present with some similar symptoms, the presence of Osler's nodes is more specific to endocarditis. Pericarditis typically presents with chest pain, not the combination of symptoms seen in this case.

3. The doctor has ordered 1,000 cc of intravenous fluid every 8 hours. You will be using intravenous tubing that delivers 20 cc/drop. At what rate will you adjust the intravenous fluid flow? _____ gtts per minute.

• A. 38 gtts/min
• B. 42 gtts/min
• C. 50 gtts/min
• D. 40 gtts/min

Correct answer: D

Rationale: To calculate the rate: 1000 cc/8 hours = 125 cc/hour. 125 cc/hour * 1 drop/20 cc * 1 hour/60 minutes = 40 gtts/min. Therefore, the correct answer is 40 gtts/min. Choice A (38 gtts/min) is incorrect as it doesn't match the calculation result. Choice B (42 gtts/min) is incorrect as it is not the calculated rate. Choice C (50 gtts/min) is incorrect as it is not the calculated rate either.

4. Clients with type 1 diabetes may require which of the following changes to their daily routine during periods of infection?

• A. No change
• B. Less insulin
• C. More insulin
• D. Oral antidiabetic agents

Correct answer: C

Rationale: During periods of infection, clients with type 1 diabetes may require more insulin to manage the increased blood glucose levels caused by stress and illness. Insulin needs often rise during infections due to the body's increased resistance to the effects of insulin. Therefore, increasing insulin doses is crucial to maintain blood glucose control. Choices A, B, and D are incorrect. Option A ('No change') is inaccurate because during infections, insulin requirements typically increase. Option B ('Less insulin') is incorrect as the body's increased insulin resistance during infections usually necessitates higher insulin doses. Option D ('Oral antidiabetic agents') is not suitable for type 1 diabetes management as these medications are primarily used for type 2 diabetes.

5. The doctor has ordered 500 mg of a medication PO once a day. The tablets on hand are labeled as 1 tablet = 250 mg. How many tablets will you administer to your patient?

• A. 1 Tablet
• B. 2 Tablets
• C. 3 Tablets
• D. 4 Tablets

Correct answer: B

Rationale: To calculate the number of tablets needed, divide the total dosage prescribed (500 mg) by the dosage per tablet (250 mg per tablet). 500 mg / 250 mg per tablet = 2 tablets. Therefore, the correct answer is 2 tablets. Choices A, C, and D are incorrect as they do not accurately reflect the correct calculation based on the provided information.

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