Nursing Elites

1. A health care provider asks the nurse to administer a medication with a dosage significantly higher than usual. What is the nurse's first action?

• A. Administer the medication as ordered.
• B. Question the provider and verify the dose.
• C. Administer half the dosage as a precaution.
• D. Refuse to administer the medication without clarification.

Correct answer: B

Rationale: When a health care provider orders a medication with a dosage significantly higher than usual, the nurse's initial action should be to question the provider and verify the dose. This is crucial to ensure patient safety and prevent medication errors. Administering the medication as ordered (Choice A) without clarification could potentially harm the patient if there was an error in the prescription. Administering half the dosage as a precaution (Choice C) is not a safe practice as it deviates from the prescribed order. Refusing to administer the medication without clarification (Choice D) is important, but the first step should be to seek clarification from the provider to prevent any unnecessary delays in patient care.

2. Which intervention is most effective for managing a patient with constipation?

• A. Increase the patient's fluid intake.
• B. Administer a stool softener as prescribed.
• C. Provide the patient with a high-fiber diet.
• D. Teach the patient to perform Valsalva maneuvers.

Correct answer: B

Rationale: The most effective intervention for managing constipation in a patient is to administer a stool softener as prescribed. Stool softeners help relieve constipation by making the stool easier to pass, especially in postoperative patients. Increasing fluid intake can be beneficial but may not address the underlying cause of constipation. While a high-fiber diet is important for bowel health, it may not provide immediate relief for constipation. Teaching a patient to perform Valsalva maneuvers is not recommended for managing constipation as it can lead to adverse effects like increasing intra-abdominal pressure.

3. A client with a history of falls is under the care of a nurse. Which intervention is most important to implement?

• A. Increase the frequency of bed checks.
• B. Use bed alarms to prevent falls.
• C. Keep the room well lit during the day.
• D. Encourage the client to use a walker for mobility.

Correct answer: B

Rationale: Using bed alarms to prevent falls is the most important intervention to implement for a client with a history of falls. Bed alarms can provide timely alerts to the healthcare team, allowing for quick assistance to prevent falls. Increasing the frequency of bed checks may not necessarily prevent falls as effectively as direct intervention with bed alarms. Keeping the room well lit is important for general safety but may not address the immediate risk of falls. Encouraging the client to use a walker for mobility is beneficial but may not be as crucial as implementing bed alarms to prevent falls in this scenario.

4. When teaching a patient with a new prescription for brimonidine to treat open-angle glaucoma, what indicates an understanding of the instructions?

• A. I can expect my vision to improve quickly
• B. I should use it only when my eyes are irritated
• C. I can expect to feel some irritation when I put these drops in my eyes
• D. I will need regular eye exams

Correct answer: C

Rationale: The correct answer is C. When using brimonidine to treat open-angle glaucoma, patients may experience temporary irritation in the eyes. Choice A is incorrect because vision improvement from brimonidine is not immediate. Choice B is incorrect as brimonidine should be used as prescribed, not just when eyes are irritated. Choice D is important but does not directly indicate an understanding of the medication's use.

5. A nurse in the PACU is caring for a client who has received general anesthesia and has a manifestation of malignant hyperthermia. The nurse should expect to administer which of the following medications?

• A. Acetaminophen
• B. Ibuprofen
• C. Dantrolene
• D. Diazepam

Correct answer: C

Rationale: Corrected Rationale: Dantrolene is the medication of choice to treat malignant hyperthermia, a life-threatening reaction to general anesthesia. It works by inhibiting the release of calcium ions in skeletal muscle cells, preventing muscle contracture and hypermetabolism. Acetaminophen (Choice A) and ibuprofen (Choice B) are not indicated for treating malignant hyperthermia. Diazepam (Choice D) may be used to control muscle spasms but is not the first-line treatment for malignant hyperthermia.

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