GCC 226 - 250

The nurse is reviewing a history on a new admission for surgery in the morning. Which long-term medication in the client's history would be most important to report to the physician?

• Prednisone
• Lisinopril (Zestril)
• Docusate (Colace)
• Calcium carbonate (Oscal D)

Answer explanation

Option 1: Prednisone

Option 2: Lisinopril (Zestril)

Option 3: Docusate (Colace)

Option 4: Calcium carbonate (Oscal D)

Correct Option: Option 1 – Prednisone

Explanation: Steroid withdrawal can cause cardiovascular collapse — physician must be notified.

A client with a deep decubitus ulcer is receiving therapy in the hyperbaric oxygen chamber. Before therapy, the nurse should:

• Apply a lanolin-based lotion to the skin
• Wash the skin with water and pat dry
• Cover the area with a petroleum gauze
• Apply an occlusive dressing to the site

Answer explanation

Option 1: Apply a lanolin-based lotion to the skin

Option 2: Wash the skin with water and pat dry

Option 3: Cover the area with a petroleum gauze

Option 4: Apply an occlusive dressing to the site

Correct Option: Option 2 – Wash the skin with water and pat dry

Explanation: Lotions or dressings interfere with oxygenation; simple water cleaning is best.

A nurse states to a nurse coworker, "The education coordinator and the charge nurse keep asking me for my new CPR and ACLS cards. I suppose that they will let me know when those certifications are about to expire." What is the appropriate response by the nurse coworker regarding the nurse's responsibility for continuing education?

• They have a list of when your certifications expire and they continue to remind you until you recertify and bring them the new cards as proof of recertification.
• You will not be allowed to work if those certifications expire.
• Yes, they remind all of the nurses about certifications that are due to be renewed. You would think that they had more important things to accomplish.
• Renewal of certifications required for employment and your nursing license are your responsibility as a nurse. You are fortunate that they care and that they reminded you that your certifications were due for renewal.

Answer explanation

Option 1: They have a list of when your certifications expire and they continue to remind you until you recertify and bring them the new cards as proof of recertification.

Option 2: You will not be allowed to work if those certifications expire.

Option 3: Yes, they remind all of the nurses about certifications that are due to be renewed. You would think that they had more important things to accomplish.

Option 4: Renewal of certifications required for employment and your nursing license are your responsibility as a nurse. You are fortunate that they care and that they reminded you that your certifications were due for renewal.

Correct Option: Option 4 – Renewal of certifications required for employment and your nursing license are your responsibility as a nurse. You are fortunate that they care and that they reminded you that your certifications were due for renewal.

Explanation: Nurses are accountable for maintaining required licenses and certifications.

A client is being discharged to a rehabilitation facility. The primary nurse caring for the client on the day of discharge carefully inventories the client's belongings and checks the list against the admission list of belongings for accuracy. The nurse then makes a client report for the nurse assuming client care at the receiving rehabilitation facility and answers the receiving nurse's questions before concluding the report. The nurse has demonstrated which element of a safe client care environment?

• Continuity of care.
• Case management.
• Quality improvement.
• Courteous and respectful care.

Answer explanation

Option 1: Continuity of care.

Option 2: Case management.

Option 3: Quality improvement.

Option 4: Courteous and respectful care.

Correct Option: Option 1 – Continuity of care.

Explanation: These actions show clear coordination and communication across transitions.

Which component of the multidisciplinary health care team has been shown, in multiple studies, to decrease clients' length of stay in health care facilities, decrease the cost of health care to the client, and improve continuity of care?

• Outcomes management.
• Risk management.
• Case management.
• Infection control.

Answer explanation

Option 1: Outcomes management.

Option 2: Risk management.

Option 3: Case management.

Option 4: Infection control.

Correct Option: Option 3 – Case management.

Explanation: Case management enhances care quality, lowers costs, and shortens stays.

A client with myasthenia gravis is admitted with a diagnosis of cholinergic crisis. The nurse can expect the client to have:

• Decreased blood pressure and pupillary meiosis
• Increased heart rate and increased respirations
• Increased respirations and increased blood pressure
• Anoxia and absence of the cough reflex

Answer explanation

Option 1: Decreased blood pressure and pupillary meiosis

Option 2: Increased heart rate and increased respirations

Option 3: Increased respirations and increased blood pressure

Option 4: Anoxia and absence of the cough reflex

Correct Option: Option 1 – Decreased blood pressure and pupillary meiosis

Explanation: Cholinergic crisis from overmedication leads to nausea, vomiting, low BP, pupillary constriction.

According to traditional Chinese medicine, what is defined as the vital energy of the human body?

• Meridians
• Yin and yang
• Acupoints
• Qi

Answer explanation

Option 1: Meridians

Option 2: Yin and yang

Option 3: Acupoints

Option 4: Qi

Correct Option: Option 4 – Qi

Explanation: Qi is considered the body's vital energy; meridians channel it, acupoints influence it.

The nurse is teaching the pregnant client ways to prevent heartburn. The nurse should tell the client to:

• Sleep on her right side
• Eat dry crackers at bedtime
• Sleep on a small pillow
• Avoid caffeinated beverages

Answer explanation

Option 1: Sleep on her right side

Option 2: Eat dry crackers at bedtime

Option 3: Sleep on a small pillow

Option 4: Avoid caffeinated beverages

Correct Option: Option 4 – Avoid caffeinated beverages

Explanation: Caffeine triggers heartburn; head elevation and left side sleep recommended.

The chart of a client with schizophrenia states that the client has echolalia. The nurse can expect the client to:

• Speak using words that rhyme
• Repeat words or phrases used by others
• Include irrelevant details in conversation
• Make up new words with new meanings

Answer explanation

Option 1: Speak using words that rhyme

Option 2: Repeat words or phrases used by others

Option 3: Include irrelevant details in conversation

Option 4: Make up new words with new meanings

Correct Option: Option 2 – Repeat words or phrases used by others

Explanation: Echolalia is the repetition of others' speech; common in schizophrenia.

A patient with thrombocytopenia secondary to leukemia develops epistaxis. What should the nurse instruct the patient to do?

• Lie supine with his neck extended
• Sit upright, leaning slightly forward
• Blow his nose and then put lateral pressure on it
• Hold his nose while bending forward at the waist

Answer explanation

Option 1: Lie supine with his neck extended

Option 2: Sit upright, leaning slightly forward

Option 3: Blow his nose and then put lateral pressure on it

Option 4: Hold his nose while bending forward at the waist

Correct Option: Option 2 – Sit upright, leaning slightly forward

Explanation: Forward-leaning posture prevents aspiration and helps manage bleeding.