Nursing Elites

1. A client is diagnosed with tuberculosis and is placed on isoniazid (INH) and rifampin (Rifadin). The nurse should emphasize the importance of

• A. Daily use of a bronchodilator
• B. The importance of taking medication as prescribed
• C. Decreasing salt intake
• D. Avoidance of direct sunlight

Correct answer: B

Rationale: The correct answer is B: The importance of taking medication as prescribed. In the treatment of tuberculosis, adherence to the prescribed medication regimen is crucial to effectively manage the infection and prevent the development of drug resistance. Choices A, C, and D are incorrect because bronchodilators, salt intake, and sunlight exposure are not directly related to the treatment of tuberculosis with isoniazid and rifampin.

2. A client with diabetes mellitus presents with a blood sugar level of 320 mg/dL. What is the nurse's initial action?

• A. Administer sliding scale insulin as prescribed
• B. Encourage the client to drink fluids
• C. Provide the client with a carbohydrate snack
• D. Assess the client for signs of hypoglycemia

Correct answer: A

Rationale: When a client with diabetes mellitus presents with a high blood sugar level of 320 mg/dL, the nurse's initial action should be to administer sliding scale insulin as prescribed. The priority is to bring down the elevated glucose level promptly to prevent further complications. Encouraging the client to drink fluids or providing a carbohydrate snack would not effectively address the elevated blood sugar level in this scenario. Assessing for signs of hypoglycemia is not appropriate as the client's blood sugar level is high, not low.

3. The nurse is caring for a client with a suspected myocardial infarction (MI). Which laboratory test result is most indicative of a recent MI?

• A. Elevated troponin levels
• B. Increased white blood cell count
• C. Increased lactate dehydrogenase (LDH)
• D. Elevated C-reactive protein (CRP)

Correct answer: A

Rationale: Elevated troponin levels are the most specific and sensitive indicator of myocardial infarction. Troponin levels increase within hours of an MI and remain elevated for several days. White blood cell count, lactate dehydrogenase (LDH), and C-reactive protein (CRP) are not specific markers for MI. An increased white blood cell count may indicate inflammation or infection, increased LDH levels can be seen in various conditions like liver disease or muscle injury, and elevated CRP is a general marker of inflammation rather than specific to MI.

4. A client on long-term corticosteroid therapy for rheumatoid arthritis presents with weakness and hypotension. What is the nurse's first action?

• A. Administer a PRN dose of corticosteroids.
• B. Place the client in a supine position.
• C. Encourage oral fluid intake.
• D. Review the client's recent medication history.

Correct answer: A

Rationale: Administering a PRN dose of corticosteroids is the correct first action when a client on long-term corticosteroid therapy presents with weakness and hypotension. In this scenario, the client is likely experiencing adrenal insufficiency due to prolonged corticosteroid use. Administering corticosteroids promptly can help correct this insufficiency and improve the client's symptoms. Placing the client in a supine position may be necessary for symptomatic hypotension, but addressing the root cause with corticosteroids is more crucial initially. Encouraging oral fluid intake is important for many conditions but is not the priority in this case. Reviewing the client's recent medication history can provide valuable information but is not the first action needed to address the client's current presentation.

5. The nurse is caring for a client with a history of congestive heart failure (CHF) who is receiving digoxin therapy. The client reports seeing halos around lights. Which action should the nurse take?

• A. Assess the client's digoxin level
• B. Increase the client's fluid intake
• C. Check the client's blood pressure
• D. Administer a dose of potassium

Correct answer: A

Rationale: Seeing halos around lights is a classic symptom of digoxin toxicity. The nurse should assess the client's digoxin level to determine if the dose needs to be adjusted or if the medication should be held. Increasing fluid intake or checking blood pressure would not directly address the symptom of halos around lights. Administering a dose of potassium is not indicated without knowing the digoxin level and could potentially worsen the toxicity.

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