Nursing Elites

1. The client is complaining of painful swallowing secondary to mouth ulcers. Which statement by the client indicates appropriate management?

• A. “I will brush my teeth with a soft-bristle toothbrush.”
• B. “I will rinse my mouth with Listerine mouthwash.”
• C. “I will swish my antifungal solution and then swallow.”
• D. “I will avoid spicy foods, tobacco, and alcohol.”

Correct answer: D

Rationale: The correct answer is D. Avoiding irritants like spicy foods, tobacco, and alcohol is crucial in managing mouth ulcers as they can further irritate and worsen the condition. Choice A is incorrect as using a soft-bristle toothbrush may still cause discomfort. Choice B is incorrect as alcohol-containing mouthwashes can be irritating. Choice C is incorrect as swallowing antifungal solution meant for topical use is not appropriate and can be harmful.

2. In a routine sputum analysis, which of the following indicates proper nursing action before sputum collection?

• A. Secure a clean container
• B. Discard the container if the outside becomes dirty
• C. Rinse the client's mouth with Listerine before collection
• D. Tell the client that 4 tablespoons of sputum are needed

Correct answer: A

Rationale: The correct answer is to secure a clean container before sputum collection. This is essential to prevent contamination of the specimen, ensuring accurate test results and avoiding the introduction of external particles or bacteria. Choice B is incorrect because discarding the container if the outside becomes dirty is not necessary; the cleanliness of the inside is crucial. Choice C is incorrect as rinsing the client's mouth with Listerine before collection may introduce unwanted substances that can affect the test results. Choice D is incorrect as the amount of sputum required can vary depending on the test, and specifying a specific amount without medical guidance is not appropriate.

3. Which of the following is a specialized medical treatment and teaching facility that provides general and specialized medical and dental care and treatment?

• A. CONUS
• B. MEDCEN
• C. MEDCOM
• D. MEDDAC

Correct answer: B

Rationale: The correct answer is B, 'MEDCEN.' A MEDCEN (Medical Center) is a specialized medical treatment and teaching facility that offers general and specialized medical and dental care. Choice A, 'CONUS,' refers to the continental United States and is not related to medical facilities. Choice C, 'MEDCOM,' stands for Medical Command, which is an administrative entity responsible for overseeing medical units, not providing direct care. Choice D, 'MEDDAC,' refers to Medical Department Activity, which is a smaller medical unit compared to a MEDCEN and may not provide the same level of specialized care.

4. The nurse prepares to administer digoxin (Lanoxin) to a newborn with a diagnosis of heart failure and notes that the apical rate is 140 beats per minute. Which nursing action is appropriate?

• A. Hold the medication
• B. Administer the digoxin
• C. Notify the healthcare provider
• D. Recheck the apical rate in 1 hour

Correct answer: B

Rationale: An apical rate of 140 bpm is within the normal range for a newborn. Digoxin is commonly used to treat heart failure by increasing the strength and efficiency of the heart's contractions. Since the heart rate is within the normal range, there is no need to hold the medication or notify the healthcare provider. Rechecking the apical rate in an hour is unnecessary as the heart rate is not alarming. Therefore, the appropriate nursing action is to administer the digoxin.

5. A client takes an antidepressant and oral contraceptives. Which herbal supplement should the nurse educate the client about as a potential drug-herb interaction?

• A. Iron supplement
• B. Garlic
• C. Green tea
• D. St. John’s Wort

Correct answer: D

Rationale: St. John’s Wort is the correct answer because it can interact with antidepressants and oral contraceptives, potentially affecting their efficacy. Iron supplement, garlic, and green tea do not typically interact with antidepressants or oral contraceptives to the same extent as St. John’s Wort.

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