Nursing Elites

1. A community health nurse is developing a program to address the opioid crisis in the community. Which intervention should the nurse prioritize?

• A. Providing education on the dangers of opioid use
• B. Distributing naloxone kits to first responders
• C. Offering support groups for individuals struggling with addiction
• D. Partnering with local pharmacies to monitor prescriptions

Correct answer: B

Rationale: The correct answer is B: Distributing naloxone kits to first responders. Naloxone is a medication that can rapidly reverse opioid overdose, potentially saving lives. In an opioid crisis scenario, providing naloxone kits to first responders equips them to act swiftly in emergencies. Choice A, providing education on the dangers of opioid use, is important but may not be as immediately life-saving as naloxone distribution. Choice C, offering support groups, is valuable for long-term recovery but may not address the acute crisis of overdoses. Choice D, partnering with local pharmacies to monitor prescriptions, focuses on prevention rather than immediate response to overdoses.

2. The client is receiving warfarin (Coumadin) therapy. Which statement by the client indicates a need for further teaching?

• A. I will avoid eating foods high in vitamin K.
• B. I will use a soft toothbrush and an electric razor.
• C. I will keep all appointments for blood tests.
• D. I will avoid participating in contact sports.

Correct answer: D

Rationale: The correct answer is D because participating in contact sports can increase the risk of injury and bleeding in a client receiving warfarin therapy. Warfarin is a blood thinner, and activities with a higher risk of injury should be avoided to prevent bleeding complications. Choices A, B, and C are all correct statements for a client on warfarin therapy. Avoiding foods high in vitamin K helps maintain consistent anticoagulation levels, using a soft toothbrush and an electric razor reduces the risk of bleeding gums and cuts, and keeping appointments for blood tests ensures proper monitoring of the client's international normalized ratio (INR) levels.

3. A client with a history of alcoholism is admitted with pancreatitis. Which assessment finding is most important for the nurse to report to the healthcare provider?

• A. Nausea and vomiting.
• B. Epigastric pain radiating to the back.
• C. Temperature of 102°F (38.9°C).
• D. Mild jaundice.

Correct answer: C

Rationale: A temperature of 102°F (38.9°C) is the most important assessment finding to report to the healthcare provider in a client with pancreatitis and a history of alcoholism. Fever in this context can indicate infection, which is a serious complication requiring immediate intervention. Nausea and vomiting (choice A) are common symptoms of pancreatitis but may not require immediate intervention unless severe. Epigastric pain radiating to the back (choice B) is a classic symptom of pancreatitis and should be addressed, but a fever takes precedence. Mild jaundice (choice D) may be present in pancreatitis but is not as urgent as a high temperature signaling possible infection.

4. A home health nurse is reviewing the laboratory results for several clients with heart failure. Which client finding would the nurse report to the health care provider immediately?

• A. Total cholesterol 190
• B. Glycosylated hemoglobin of 7%
• C. B-type natriuretic peptide 550 pg/ml (more than 100 is concerning)
• D. Potassium 3.7

Correct answer: C

Rationale: An elevated B-type natriuretic peptide level indicates worsening heart failure, requiring immediate attention. This biomarker reflects the severity of heart failure and helps guide treatment decisions. Total cholesterol and glycosylated hemoglobin are important for assessing cardiovascular risk and diabetes management but are not indicative of acute heart failure exacerbation. A potassium level of 3.7 falls within the normal range and does not suggest an immediate concern in the context of heart failure.

5. The nurse obtains a pulse rate of 89 beats/min for an infant before administering digoxin (Lanoxin). What action should the nurse take?

• A. Administer the medication.
• B. Hold the medication and contact the healthcare provider.
• C. Double the dose.
• D. Increase fluid intake.

Correct answer: B

Rationale: The correct answer is to hold the medication and contact the healthcare provider. Bradycardia (pulse rate less than 100 beats/minute) is an early sign of digoxin toxicity. It is essential to withhold digoxin and notify the healthcare provider to prevent potential adverse effects. Administering the medication (Choice A) could exacerbate the toxicity. Doubling the dose (Choice C) is inappropriate and dangerous. Increasing fluid intake (Choice D) is not indicated in this situation and does not address the issue of digoxin toxicity.

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