Nursing Elites

1. The nurse is administering a beta blocker to the client diagnosed with essential hypertension. Which data would cause the nurse to question administering the medication?

• A. The client’s BP is 110/70
• B. The client’s potassium level is 3.4 mEq/L
• C. The client has a barky cough
• D. The client’s apical pulse is 56

Correct answer: D

Rationale: The correct answer is D. A beta blocker should be withheld if the apical pulse is below 60, as it can further decrease the heart rate. Choice A is not a reason to question administering the medication as the blood pressure is within a normal range for a client with essential hypertension. Choice B is not directly related to the administration of a beta blocker. Choice C suggests a potential side effect of an ACE inhibitor, not a beta blocker.

2. The best position for any procedure that involves vaginal and cervical examination is

• A. Dorsal recumbent
• B. Side lying
• C. Supine
• D. Lithotomy

Correct answer: D

Rationale: The lithotomy position is the most suitable position for procedures involving vaginal and cervical examination because it provides the best access to the vaginal and cervical regions. In this position, the patient lies on their back with their legs flexed and feet placed in stirrups, allowing for optimal visualization and access to the area. This position facilitates proper examination, diagnosis, and treatment when working in the gynecological field. The other options (dorsal recumbent, side lying, and supine) do not provide the same level of access and visualization as the lithotomy position, making them less ideal for vaginal and cervical examinations.

3. One of the reasons hospital patients are at greater risk for drug-nutrient interactions than they used to be is because:

• A. Hospitalized patients are more acutely ill
• B. Hospital routines interfere with the correct timing of medications
• C. Drugs used today are more toxic and have more side effects
• D. Responsibility for monitoring this is shared by various members of the healthcare team

Correct answer: A

Rationale: The correct answer is A. Hospitalized patients are more acutely ill, often having multiple conditions and treatments, which increases the risk of drug-nutrient interactions. Choice B is incorrect because hospital routines do not specifically interfere with the timing of medications in relation to drug-nutrient interactions. Choice C is incorrect because the toxicity and side effects of drugs do not directly relate to an increased risk of drug-nutrient interactions. Choice D is incorrect as sharing responsibility for monitoring does not inherently increase the risk of drug-nutrient interactions in hospital patients.

4. What is the most crucial and most difficult management skill required of the M6 practical nurse?

• A. Preparing time schedules and task assignment rosters
• B. Inspecting equipment for damage and proper function
• C. Preparing reports and maintaining records
• D. Effectively managing personnel

Correct answer: D

Rationale: Correct. Effectively managing personnel is indeed the most crucial and difficult management skill required of a practical nurse. This skill involves supervising, motivating, and coordinating the work of other healthcare staff, ensuring optimal patient care. Choices A, B, and C are important tasks but do not necessarily involve the same level of complexity and interpersonal skills required for managing personnel in a healthcare setting.

5. The nurse is preparing the plan of care for a client with fluid volume deficit. Which interventions should the nurse include in the plan of care?

• A. Monitor vital signs every two (2) hours until stable
• B. Weigh the client in the same clothing at the same time daily
• C. Administer mouth care every eight (8) hours
• D. A, B, and C

Correct answer: D

Rationale: The correct interventions for a client with fluid volume deficit include monitoring vital signs every two hours until stable, weighing the client in the same clothing at the same time daily, and assessing skin turgor. Monitoring vital signs helps in early detection of changes, daily weighing can indicate fluid retention or loss, and skin turgor assessment is a reliable indicator of hydration status. Administering mouth care every eight hours is not directly related to managing fluid volume deficit and should not be included in the plan of care for this specific condition.

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