Nursing Elites

1. Who is at higher risk for drug-nutrient interactions?

• A. Infants
• B. People with diabetes
• C. Women of childbearing age
• D. Older men and women

Correct answer: D

Rationale: Older men and women are at higher risk for drug-nutrient interactions due to factors such as polypharmacy and physiological changes. Polypharmacy, common in older adults, increases the likelihood of interactions between drugs and nutrients. Physiological changes that occur with aging can affect how drugs and nutrients are absorbed, distributed, metabolized, and excreted in the body. Infants, people with diabetes, and women of childbearing age are not typically considered high-risk groups for drug-nutrient interactions compared to older adults.

2. The client is admitted to the emergency department complaining of acute epigastric pain and reports vomiting a large amount of bright red blood at home. Which interventions should the nurse implement?

• A. Assess the client’s vital signs
• B. Start an IV with an 18-gauge needle
• C. Begin iced saline lavage
• D. A, B

Correct answer: D

Rationale: In this scenario, the client's presentation of acute epigastric pain and vomiting bright red blood indicates a potential gastrointestinal bleeding emergency. Assessing the client's vital signs is essential to monitor their hemodynamic status. Starting an IV with an 18-gauge needle is crucial to establish access for potential fluid resuscitation or blood transfusion. Beginning iced saline lavage is not appropriate in this situation and could potentially delay necessary interventions. Therefore, the correct interventions for the nurse to implement are to assess the client’s vital signs and start an IV, making option D the most appropriate choice. Options A and B are correct because they are essential initial steps in managing gastrointestinal bleeding. Option C is incorrect as iced saline lavage is not indicated and may not address the urgent needs of the client in this critical situation.

3. The client is diagnosed with pericarditis. When assessing the client, the nurse is unable to auscultate a friction rub. Which action should the nurse implement?

• A. Notify the healthcare provider
• B. Document that the pericarditis has resolved
• C. Ask the client to lean forward and listen again
• D. Prepare to insert a unilateral chest tube

Correct answer: C

Rationale: The correct action for the nurse to take when unable to auscultate a pericardial friction rub in a client diagnosed with pericarditis is to ask the client to lean forward and listen again. This position brings the heart closer to the chest wall, making it easier to detect a friction rub if present. Notifying the healthcare provider is not necessary at this point as it may just be a matter of positioning for better auscultation. Documenting that the pericarditis has resolved is premature without proper assessment. Preparing to insert a unilateral chest tube is not indicated based on the absence of a friction rub.

4. Before administering an MMR (measles, mumps, and rubella) vaccine to a 15-month-old, which question should the nurse ask the mother of the child?

• A. “Has your child had any sore throats?”
• B. “Has your child been eating properly?”
• C. “Is your child allergic to any antibiotics?”
• D. “Has your child been exposed to any infections?”

Correct answer: C

Rationale: The correct question the nurse should ask the mother before administering an MMR vaccine to a 15-month-old is whether the child is allergic to any antibiotics. This is crucial because vaccines like MMR contain components that the child could be allergic to, such as neomycin. Checking for antibiotic allergies is essential to prevent adverse reactions to the vaccine. The other options are less relevant in this context. Asking about sore throats, eating habits, or exposure to infections does not directly impact the administration of the MMR vaccine.

5. A client scheduled for surgery cannot sign the operative consent form because he has been sedated with opioid analgesics. The nurse should take which best action regarding the informed consent?

• A. Obtain a court order for the surgery
• B. Sign the informed consent on behalf of the client
• C. Send the client to surgery without the consent form being signed
• D. Obtain a telephone consent from a family member, with the consent being witnessed by two healthcare providers

Correct answer: D

Rationale: In situations where a client is unable to sign the consent form, obtaining a telephone consent from a family member, with the consent being witnessed by two healthcare providers, is the best course of action. This ensures that the client's best interests are considered and that proper authorization is obtained. Option A, obtaining a court order, is not necessary in this scenario and could delay the surgery. Option B, signing the consent on behalf of the client, is not appropriate as it may raise ethical and legal concerns. Option C, sending the client to surgery without a signed consent form, is not advisable as it violates the principles of informed consent and places the client at risk.

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