Nursing Elites

1. A charge nurse is discussing the responsibility of nurses caring for clients who have C. difficile. Which of the following information should the nurse include in the teaching?

• A. Assign the client to a room with a negative air-flow system
• B. Use alcohol-based hand sanitizer when leaving the client's room
• C. Clean contaminated surfaces in the client's room with a phenol solution
• D. Have family members wear a gown and gloves when visiting

Correct answer: D

Rationale: The correct answer is D because having family members wear a gown and gloves when visiting clients with C. difficile is crucial to prevent the transmission of the infection. Options A, B, and C are incorrect because assigning the client to a room with a negative air-flow system, using alcohol-based hand sanitizer, and cleaning contaminated surfaces with a phenol solution are not specific measures for preventing the spread of C. difficile.

2. A healthcare professional is preparing to transfer a client who has had a stroke and is at risk for falling to a rehabilitation facility. Which of the following information should the healthcare professional include in the transfer report?

• A. The client's urination habits.
• B. The client's financial information.
• C. The client's social history.
• D. The client's current level of mobility.

Correct answer: D

Rationale: The client's current level of mobility is essential to be included in the transfer report for the rehabilitation facility to develop an appropriate care plan. Understanding the client's mobility status helps in determining the level of assistance and interventions needed to prevent falls and promote safe rehabilitation. Choices A, B, and C are not directly related to the client's immediate care needs during the transfer to the rehabilitation facility, making them less relevant for the transfer report.

3. A nurse is preparing to administer metoclopramide 10 mg IM. Available is metoclopramide 5 mg/mL. How many mL should the nurse administer?

• A. 1 mL
• B. 2 mL
• C. 3 mL
• D. 4 mL

Correct answer: B

Rationale: To administer 10 mg of metoclopramide, the nurse should administer 2 mL (10 mg / 5 mg per mL). Therefore, the correct answer is 2 mL. Choice A (1 mL) is incorrect because it would only deliver 5 mg of metoclopramide, which is half the required dose. Choice C (3 mL) and D (4 mL) are incorrect as they would provide more than the required dose of 10 mg.

4. A client is receiving phenytoin for management of grand mal seizures and has a new prescription for isoniazid and rifampin. Which of the following should the nurse conclude if the client develops ataxia and incoordination?

• A. The client is experiencing an adverse reaction to rifampin.
• B. The client's seizure disorder is no longer under control.
• C. The client is showing evidence of phenytoin toxicity.
• D. The client is having adverse effects due to combination antimicrobial therapy.

Correct answer: C

Rationale: Ataxia and incoordination are signs of phenytoin toxicity rather than adverse reactions to rifampin or isoniazid. These symptoms indicate that the client is experiencing an adverse effect of phenytoin, requiring a dose adjustment. Choice A is incorrect because rifampin is not typically associated with ataxia and incoordination. Choice B is incorrect as the development of ataxia and incoordination does not necessarily mean the seizure disorder is no longer under control. Choice D is incorrect as the symptoms are more indicative of phenytoin toxicity rather than adverse effects of combination antimicrobial therapy.

5. What are the key differences between viral and bacterial infections?

• A. Viral infections typically last longer than bacterial infections.
• B. Bacterial infections typically cause high fever.
• C. Both bacterial and viral infections cause rashes.
• D. Viral infections cause sudden onset of symptoms.

Correct answer: A

Rationale: The correct answer is A. Viral infections typically last longer than bacterial infections. This is because viral infections often require the body's immune system to fight off the virus, leading to a longer duration of illness. Bacterial infections, on the other hand, often cause a rapid onset of symptoms due to the toxins produced by bacteria. Choice B is incorrect because not all bacterial infections cause high fever. Choice C is incorrect because rashes can be caused by both bacterial and viral infections, but not always. Choice D is incorrect because while some viral infections may cause a sudden onset of symptoms, it is not a key distinguishing factor between viral and bacterial infections.

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