Nursing Elites

1. A client with cirrhosis is experiencing pruritus. Which intervention should the nurse include in the care plan?

• A. Administer antihistamines as prescribed
• B. Apply alcohol-based lotions to the skin
• C. Encourage frequent baths with hot water
• D. Limit fluid intake

Correct answer: A

Rationale: The correct answer is A: Administer antihistamines as prescribed. Pruritus, or itching, is a common symptom in clients with cirrhosis. Antihistamines can help relieve itching by blocking the effects of histamine. Applying alcohol-based lotions (choice B) can further dry out the skin and exacerbate itching. Encouraging frequent baths with hot water (choice C) can also worsen pruritus by stripping the skin of natural oils. Limiting fluid intake (choice D) is not directly related to managing pruritus in cirrhosis.

2. A hospitalized toddler who is recovering from a sickle cell crisis holds a toy and says 'Mine'. According to Erikson's theory of psychosocial development, this child's behavior is a demonstration of which developmental stage?

• A. Autonomy vs. Shame and Doubt
• B. Industry vs. Inferiority
• C. Initiative vs. Guilt
• D. Trust vs. Mistrust

Correct answer: A

Rationale: The correct answer is A: Autonomy vs. Shame and Doubt. In Erikson's theory, toddlers aged 1-3 years are in the Autonomy vs. Shame and Doubt stage. During this stage, children begin to assert their independence and control over their environment. The behavior of the hospitalized toddler holding a toy and saying 'Mine' demonstrates the child's developing sense of autonomy and ownership. Choices B, C, and D correspond to different stages in Erikson's theory: Industry vs. Inferiority (school-age children), Initiative vs. Guilt (preschoolers), and Trust vs. Mistrust (infants), respectively, which are not applicable to the behavior described.

3. A client with a history of chronic kidney disease (CKD) is being discharged with a prescription for epoetin alfa (Epogen). What should the nurse include in the discharge teaching?

• A. Take this medication on an empty stomach.
• B. Monitor your blood pressure regularly.
• C. Expect to feel better immediately.
• D. Avoid foods high in potassium.

Correct answer: B

Rationale: The correct answer is B: 'Monitor your blood pressure regularly.' Epoetin alfa (Epogen) can lead to hypertension as a side effect, so it is essential for clients with CKD to monitor their blood pressure regularly. Choice A is incorrect because epoetin alfa does not need to be taken on an empty stomach. Choice C is incorrect because the client should not expect immediate improvement upon starting the medication. Choice D is incorrect because while monitoring potassium intake is important in CKD, the question specifically pertains to epoetin alfa and its side effects, not potassium intake.

4. The nurse is assessing an older resident with a history of Benign Prostatic Hypertrophy and identifies a distended bladder. What should the nurse do?

• A. Stand the client to void and run tap water within hearing distance before catheterizing
• B. Straight catheterize and if the residual urine volume is greater than 100 mL, clamp catheter
• C. Catheterize q2h and place in an indwelling catheter at the end of the prescribed 24hr period
• D. Catheterize with an indwelling catheter and if the residual volume is greater than 100 mL, inflate the balloon

Correct answer: D

Rationale: Prompt and appropriate management of urinary retention prevents complications like infection and bladder damage.

5. When reconstituted, how many milligrams are in each milliliter of solution?

• A. 300 mg/mL
• B. 350 mg/mL
• C. 450 mg/mL
• D. 400 mg/mL

Correct answer: D

Rationale: After reconstitution, the concentration of the cefazolin solution is 400 mg/mL. This calculation is derived by dividing the total milligrams in the vial (1000 mg) by the total volume after reconstitution (2.5 mL). Therefore, each milliliter of the solution contains 400 mg of cefazolin. Choices A, B, and C are incorrect as they do not match the correct calculation based on the information provided.

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