Nursing Elites

1. A client's chest tube insertion site has crepitus (crackling sensation) upon palpation. What is the nurse's next step?

• A. Apply a pressure dressing to the chest tube site.
• B. Administer an oral antihistamine.
• C. Assess the client for allergies to cleaning agents.
• D. Measure the area of swelling and crackling.

Correct answer: D

Rationale: The correct next step for the nurse is to measure the area of crepitus. Crepitus indicates subcutaneous emphysema, which is a serious condition requiring monitoring. Applying a pressure dressing (Choice A) could worsen the condition by trapping air under the skin. Administering an oral antihistamine (Choice B) is not indicated for crepitus. Assessing for allergies to cleaning agents (Choice C) is not the priority when dealing with crepitus and subcutaneous emphysema.

2. The healthcare provider prescribes celtazidime for an infant, IM, every 8 hours. The vial is 500 mg with a concentration of 100 mg/ml after reconstitution. How many ml should the nurse administer?

• A. 3 ml.
• B. 0.4 ml.
• C. 1.2 ml.
• D. 0.9 ml.

Correct answer: B

Rationale: To administer 35 mg of celtazidime from a 100 mg/ml solution, the nurse should give 0.4 ml of the reconstituted celtazidime solution. The calculation is 35 mg / 100 mg/ml = 0.35 ml, but since the vial is 500 mg, the answer is 0.35 ml * (500 mg / 100 mg) = 0.4 ml. Therefore, choices A, C, and D are incorrect as they do not reflect the correct calculation based on the provided information.

3. The client is being taught to choose foods rich in potassium to prevent digitalis toxicity. Which choice indicates the client understands dietary needs?

• A. Three apricots
• B. Medium banana
• C. Naval orange
• D. Baked potato

Correct answer: D

Rationale: The correct answer is D: Baked potato. Baked potatoes are rich in potassium, which is essential in preventing digitalis toxicity by helping to maintain normal electrolyte levels. Apricots, bananas, and oranges are also sources of potassium, but a baked potato has a higher potassium content compared to the other options, making it a more effective choice for preventing digitalis toxicity.

4. The nurse is planning to administer two medications at 0900. Which property of the drugs indicates a need to monitor the client for toxicity?

• A. Short half-life
• B. High therapeutic index
• C. Highly protein-bound
• D. Low bioavailability

Correct answer: C

Rationale: The correct answer is C, 'Highly protein-bound.' Drugs that are highly protein-bound can displace from protein-binding sites, leading to increased free drug levels in the blood, which can result in toxicity. Monitoring the client for toxicity is crucial when administering highly protein-bound drugs. Choices A, B, and D are incorrect. A short half-life does not necessarily indicate a need for monitoring toxicity; a high therapeutic index indicates a wide safety margin between the effective dose and the toxic dose, reducing the risk of toxicity; low bioavailability refers to the fraction of the drug that reaches the systemic circulation unchanged and does not directly relate to the risk of toxicity.

5. The nurse is providing education to a client who experiences recurrent levels of moderate anxiety in response to situations and perceived stress. In addition to information about prescribed medication and administration, which instruction should the nurse include in the teaching?

• A. Practice using muscle relaxation techniques
• B. Take medication only when anxiety is at its worst
• C. Avoid interactions that trigger stress
• D. Engage in exercise during anxious periods

Correct answer: A

Rationale: Teaching relaxation techniques, such as muscle relaxation, helps the client manage anxiety more effectively. These techniques can be practiced regularly to reduce overall anxiety and can complement prescribed medications. Choice B is incorrect because medication should be taken as prescribed, not only when anxiety is at its worst. Choice C is incorrect as avoiding interactions that trigger stress may not always be feasible and does not teach the client coping mechanisms. Choice D is incorrect as engaging in exercise during anxious periods may not be the most effective strategy for managing moderate anxiety levels.

Similar Questions