Nursing Elites

1. A client with psoriasis is prescribed topical corticosteroids. What side effect should the nurse monitor for?

• A. Monitor for weight gain and skin thinning.
• B. Assess for increased sensitivity to sunlight.
• C. Monitor for hair loss and excessive bruising.
• D. Report any signs of increased redness or itching.

Correct answer: D

Rationale: The correct answer is D. When a client with psoriasis is prescribed topical corticosteroids, the nurse should monitor for signs of increased redness or itching. This is because topical corticosteroids can cause skin thinning and increased redness if overused. Choices A, B, and C are incorrect because weight gain, sensitivity to sunlight, hair loss, and excessive bruising are not typically associated with the use of topical corticosteroids.

2. A female client taking prednisone reports feeling tired after stopping the corticosteroid abruptly. What is the priority nursing intervention?

• A. Auscultate breath sounds.
• B. Measure vital signs.
• C. Palpate the abdomen.
• D. Observe the skin for bruising.

Correct answer: C

Rationale: The correct answer is to palpate the abdomen. When a client abruptly stops taking prednisone, there is a risk of adrenal insufficiency, which can present with symptoms like fatigue. Palpating the abdomen is crucial to assess for signs of adrenal crisis, such as abdominal pain, which can indicate severe adrenal insufficiency. Auscultating breath sounds (Choice A) and observing the skin for bruising (Choice D) are not the priority interventions in this situation. While measuring vital signs (Choice B) is important, palpating the abdomen takes precedence in this case to assess for potential adrenal insufficiency.

3. A client with a peripherally inserted central catheter (PICC) line has a fever. What client assessment is most important for the nurse to perform?

• A. Inspect the PICC insertion site for signs of infection.
• B. Observe the antecubital fossa for inflammation.
• C. Auscultate lung sounds for signs of respiratory distress.
• D. Check for signs of phlebitis or thrombosis along the catheter site.

Correct answer: B

Rationale: Observing the antecubital fossa for inflammation is crucial in clients with a PICC line and fever. Inflammation at the site can indicate infection or complications related to the PICC line. Auscultating lung sounds (choice C) is important but not the priority in this situation. Checking for phlebitis or thrombosis (choice D) is relevant but does not address the immediate concern of identifying infection or complications at the insertion site. Inspecting the PICC insertion site (choice A) is also important but observing the antecubital fossa provides a more direct assessment of potential issues with the PICC line.

4. A client with Type 1 diabetes reports feeling shaky and lightheaded. The nurse checks the client's blood glucose level and it is 60 mg/dL. What action should the nurse take first?

• A. Give the client a glucagon injection
• B. Encourage the client to eat a high-protein snack
• C. Recheck the blood glucose level in 15 minutes
• D. Administer 15 grams of a fast-acting carbohydrate

Correct answer: D

Rationale: The correct answer is D: Administer 15 grams of a fast-acting carbohydrate. The first step in treating hypoglycemia is to quickly raise the client's blood sugar level. Fast-acting carbohydrates like glucose tablets or juice are essential for this purpose. Giving a glucagon injection is typically reserved for severe hypoglycemia when the client is unable to take anything by mouth. Encouraging the client to eat a high-protein snack is not appropriate for immediate treatment of hypoglycemia. Rechecking the blood glucose level in 15 minutes is important after administering the fast-acting carbohydrate to ensure that the blood sugar has returned to a safe level.

5. The nurse is administering an intradermal injection for a tuberculosis skin test. Which technique should the nurse use?

• A. Use a 25-gauge needle at a 90-degree angle
• B. Use a 27-gauge needle at a 15-degree angle
• C. Use a 22-gauge needle at a 45-degree angle
• D. Use a 20-gauge needle at a 90-degree angle

Correct answer: B

Rationale: An intradermal injection for a tuberculosis skin test should be administered using a 27-gauge needle at a 15-degree angle. This technique ensures that the medication is delivered into the dermis layer of the skin. Choice A is incorrect because a 25-gauge needle is too large for an intradermal injection. Choice C is incorrect as a 22-gauge needle is also too large and the angle is too steep for an intradermal injection. Choice D is incorrect as a 20-gauge needle is too large for an intradermal injection, and a 90-degree angle would not deliver the medication accurately into the dermis.

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