Nursing Elites

1. A client with cirrhosis and ascites is receiving furosemide 40 mg BID. The pharmacy provides 20 mg tablets. How many tablets should the client receive each day? [Enter numeric value only]

• A. 4 tablets
• B. 3 tablets
• C. 2 tablets
• D. 1 tablet

Correct answer: A

Rationale: To calculate the total daily dose of furosemide needed, 40 mg BID (twice a day) is 80 mg/day. Since each tablet is 20 mg, the client should receive a total of 4 tablets per day (80 mg ÷ 20 mg per tablet = 4 tablets). Therefore, the correct answer is 4 tablets. Choice B (3 tablets) is incorrect because it does not provide the correct total daily dose. Choice C (2 tablets) is incorrect as it would not meet the required dose of 80 mg/day. Choice D (1 tablet) is incorrect as it would be insufficient to achieve the prescribed daily dose.

2. The census on the unit is 90 percent, and there are no private rooms available. An elderly client with influenza is admitted. Which of the following rooms would it be appropriate to assign this client?

• A. A double room with a client admitted for impetigo.
• B. A double room with another client with the same diagnosis.
• C. A four-bed room with three clients who have had orthopedic surgery.
• D. A double room with an elderly client with a diagnosis of chickenpox.

Correct answer: B

Rationale: When a private room is not an option, the best choice is to assign the elderly client with influenza to a double room with another client diagnosed with the same condition. This is ideal as droplet precautions would likely already be in place for the other client, reducing the risk of spreading the infection to other clients in the unit. Choice A is not appropriate as impetigo does not require the same precautions as influenza. Choice C is not ideal as orthopedic surgery does not involve respiratory precautions. Choice D is incorrect because chickenpox requires airborne precautions, which could pose a risk to the elderly client with influenza.

3. When suctioning a tracheostomy, which action is most appropriate for the nurse to take?

• A. Use a sterile tube each time and suction for 30 seconds.
• B. Use sterile technique and turn the suction off as the catheter is introduced.
• C. Use clean technique and suction for 10 seconds.
• D. Discard the catheter at the end of every shift.

Correct answer: B

Rationale: When suctioning a tracheostomy, it is crucial to use sterile technique to prevent infections. Turning off the suction as the catheter is introduced is important to avoid trauma and injury to the tracheal walls. This technique helps maintain the integrity of the tracheostomy site and ensures proper care for the patient.

4. A client is admitted with a stage four pressure ulcer that has a black, hardened surface and a light-pink wound bed with malodorous green drainage. Which dressing is best for the nurse to use first?

• A. Hydrogel dressing.
• B. Exudate absorber.
• C. Wet-to-moist dressing.
• D. Transparent adhesive film.

Correct answer: C

Rationale: The best initial dressing for a stage four pressure ulcer with necrotic tissue is a wet-to-moist dressing. This dressing helps to provide moisture, soften necrotic tissue, and prepare the wound bed for healing. It promotes autolytic debridement and can help manage malodorous drainage. Once the necrotic tissue is loosened, other advanced dressings like hydrogel or alginate may be used in the wound bed to facilitate healing.

5. When caring for a client in hemorrhagic shock, how should the nurse position the client?

• A. Flat in bed with legs elevated.
• B. Flat in bed.
• C. Trendelenburg position.
• D. Semi-Fowler's position.

Correct answer: A

Rationale: When caring for a client in hemorrhagic shock, the nurse should position the client flat in bed with legs elevated. Elevating the legs helps increase venous return to the heart, aiding in the management of hemorrhagic shock by maintaining perfusion to vital organs.

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