Nursing Elites

1. A client with a history of hypertension is prescribed hydrochlorothiazide. Which instruction should the nurse include in the client's teaching?

• A. Take this medication in the morning.
• B. Avoid foods high in potassium.
• C. Monitor your blood pressure regularly.
• D. Decrease your intake of high-sodium foods.

Correct answer: C

Rationale: Regular monitoring of blood pressure is crucial for individuals with hypertension to assess the effectiveness of the prescribed medication and to ensure blood pressure is within the target range. This helps in managing hypertension and preventing complications associated with high blood pressure. Choices A, B, and D are incorrect because while taking the medication in the morning may be recommended for some drugs, it is not the key instruction for hydrochlorothiazide. Avoiding foods high in potassium and decreasing high-sodium foods are important dietary considerations for certain conditions, but they are not the immediate focus when starting hydrochlorothiazide.

2. A healthcare professional is preparing to administer digoxin 0.25 mg PO daily. The amount available is digoxin 0.125 mg tablets. How many tablets should the healthcare professional administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

• A. 1
• B. 2
• C. 3
• D. 4

Correct answer: B

Rationale: To achieve the prescribed dose of 0.25 mg, the healthcare professional should administer 2 tablets of 0.125 mg each, totaling 0.25 mg.

3. Because the census is currently low in the Obstetrics (OB) unit, one of the nurses is sent to work on a medical-surgical unit for the day, or until the OB unit becomes busy. Which client assessment is best for the charge nurse to assign to the OB nurse?

• A. An adult who had a colon resection yesterday and has an IV.
• B. An older adult who has a fever of unknown origin.
• C. A woman who had an acute brain attack (stroke, CVA) 6 hours ago.
• D. A teenager with a femoral fracture who is in traction.

Correct answer: A

Rationale: The OB nurse is most experienced in postoperative care, making the client who had a recent colon resection the most suitable assignment. This client would require care that aligns closely with the expertise and skills of the OB nurse, ensuring optimal patient outcomes and effective utilization of nursing resources.

4. A client with a history of gout is experiencing an acute attack. Which medication should the nurse expect the healthcare provider to prescribe?

• A. Aspirin.
• B. Allopurinol (Zyloprim).
• C. Colchicine.
• D. Probenecid (Benemid).

Correct answer: C

Rationale: During an acute gout attack, the healthcare provider is likely to prescribe colchicine. Colchicine is commonly used to treat acute gout attacks because it works by reducing inflammation and alleviating pain associated with the condition. It is important to note that aspirin is not recommended for gout treatment and may even exacerbate the symptoms. Allopurinol and probenecid are medications used for long-term management of gout by reducing uric acid levels in the blood, but they are not typically prescribed during an acute attack. Therefore, colchicine is the most appropriate medication for managing an acute gout attack.

5. The healthcare professional is caring for a client with a chest tube following a thoracotomy. Which assessment finding requires immediate intervention?

• A. Continuous bubbling in the water seal chamber.
• B. Serosanguineous drainage in the collection chamber.
• C. Intermittent bubbling in the suction control chamber.
• D. Chest tube secured to the client's chest wall.

Correct answer: A

Rationale: Continuous bubbling in the water seal chamber indicates an air leak, which requires immediate intervention to prevent complications such as pneumothorax. An air leak can lead to ineffective lung expansion, respiratory distress, and compromised gas exchange. Therefore, prompt action is necessary to maintain the integrity of the closed drainage system and prevent further complications. Choices B, C, and D are incorrect because serosanguineous drainage is an expected finding post-thoracotomy, intermittent bubbling in the suction control chamber is normal, and having the chest tube secured to the client's chest wall is essential for stability and proper functioning.

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