Nursing Elites

1. A client is being taught by a healthcare professional about preventing Otitis Externa. Which of the following instructions should the healthcare professional include?

• A. Clean the ear with a cotton-tipped swab daily
• B. Place earplugs in the ears when sleeping at night
• C. Use a cool water irrigation solution to remove earwax
• D. Tip the head to the side to remove water from the ears after showering

Correct answer: D

Rationale: To prevent Otitis Externa, it is important to remove water from the ears after showering or swimming. This helps reduce the risk of moisture buildup in the ear canal, which can lead to infection. Cleaning the ear with a cotton-tipped swab daily can actually increase the risk of injury or infection. Placing earplugs in the ears when sleeping at night may trap moisture and promote bacterial growth. Using a cool water irrigation solution to remove earwax is not recommended as it can disrupt the natural balance of the ear canal.

2. A healthcare provider is providing discharge instructions to a client who has a new prescription for Warfarin. Which of the following over-the-counter medications should the provider instruct the client to avoid?

• A. Acetaminophen
• B. Ibuprofen
• C. Diphenhydramine
• D. Loratadine

Correct answer: B

Rationale: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can increase the risk of bleeding when taken with Warfarin due to its antiplatelet effects. The combination of Warfarin, an anticoagulant, and NSAIDs can potentiate the risk of bleeding complications. Clients on Warfarin should avoid NSAIDs like ibuprofen and opt for alternative pain relief options such as acetaminophen. Diphenhydramine and loratadine are antihistamines and are generally safe to use with Warfarin as they do not significantly increase the risk of bleeding when compared to NSAIDs like ibuprofen.

3. A client with Angina Pectoris asks the nurse about the next step if one tablet does not relieve Anginal pain after waiting 5 minutes. Which of the following responses should the nurse make?

• A. Take two more sublingual tablets simultaneously.
• B. Call emergency services.
• C. Take a sustained-release nitroglycerin capsule.
• D. Wait another 5 minutes before taking a second sublingual tablet.

Correct answer: B

Rationale: In a situation where Anginal pain persists after taking one sublingual tablet and waiting 5 minutes, it is crucial to call emergency services (911) immediately. This could indicate a myocardial infarction (heart attack) rather than a typical Anginal attack. The client should not take two more sublingual tablets simultaneously without seeking immediate medical help as this could delay appropriate intervention if the pain is due to a heart attack. Taking a sustained-release nitroglycerin capsule is not recommended for immediate relief of acute Anginal pain as it works too slowly. Waiting another 5 minutes before taking a second sublingual tablet is not appropriate if the pain persists, as prompt action is essential in suspected heart-related issues.

4. When caring for a client prescribed Lithium, which laboratory value should the nurse monitor to assess for potential toxicity?

• A. Serum sodium
• B. Serum lithium
• C. Serum potassium
• D. Serum calcium

Correct answer: B

Rationale: The nurse should monitor the client's serum lithium levels to ensure they are within the therapeutic range and to assess for potential toxicity. Monitoring serum lithium levels is crucial because lithium has a narrow therapeutic range, and levels outside this range can lead to toxicity, which can be life-threatening. Therefore, regular monitoring is essential to prevent adverse effects and ensure the medication's effectiveness.

5. What is the action of Metformin?

• A. Decreasing intestinal glucose absorption
• B. Increasing sensitivity to insulin
• C. Decreasing hepatic glucose production
• D. All of the above

Correct answer: D

Rationale: Metformin exerts its effects by decreasing hepatic glucose production, increasing sensitivity to insulin, and decreasing intestinal glucose absorption. These actions help in lowering blood glucose levels and improving insulin sensitivity in individuals with diabetes.

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