Nursing Elites

1. A newly licensed nurse tells a charge nurse he is unsure about accepting telephone medication prescriptions. Which of the following providers should the charge nurse identify as having the legal ability to give telephone medication prescriptions?

• A. Nurse midwives
• B. Physical therapists
• C. Pharmacists
• D. Physician assistants

Correct answer: D

Rationale: Physician assistants are healthcare providers who are licensed to prescribe medications. They have the legal ability to give telephone orders for medications. Nurse midwives primarily focus on providing prenatal care and assisting during labor and delivery. Physical therapists specialize in rehabilitation services. Pharmacists dispense medications and provide medication counseling. Therefore, among the options provided, physician assistants are the correct choice for giving telephone medication prescriptions.

2. A nurse is providing teaching to a client who has a new prescription for warfarin. Which of the following statements by the client indicates a need for further teaching?

• A. I will take ibuprofen for headaches.
• B. I will use an electric razor to shave.
• C. I will avoid eating large amounts of leafy green vegetables.
• D. I will have my blood levels checked regularly.

Correct answer: A

Rationale: The correct answer is A. Ibuprofen can increase the risk of bleeding when taken with warfarin, as both medications affect clotting. The client should use alternative pain relievers like acetaminophen. Choice B is correct as using an electric razor is a safe choice to prevent cuts that could lead to bleeding. Choice C is correct as warfarin interacts with vitamin K found in leafy green vegetables. Choice D is correct as regular blood level checks are necessary to monitor the effects and adjust the warfarin dosage if needed.

3. A nurse is planning care for an adolescent client with chronic renal failure. Which action should the nurse include?

• A. Encourage a diet high in calcium
• B. Provide a diet high in potassium
• C. Ensure increased fluid intake
• D. Restrict protein intake to the RDA

Correct answer: D

Rationale: In chronic renal failure, it is essential to restrict protein intake to the Recommended Dietary Allowance (RDA) to reduce the accumulation of waste products that the kidneys can no longer effectively eliminate. Choices A, B, and C are incorrect because in chronic renal failure, high calcium, high potassium, and increased fluid intake can further strain the kidneys and worsen the condition.

4. A nurse in the telemetry unit is receiving the laboratory findings for an adult male client who is being treated for a myocardial infarction. Which of the following is an expected finding for the client?

• A. Troponin I (TnI) 8 ng/mL
• B. Brain natriuretic peptide (BNP) 10 ng/L
• C. Alanine aminotransferase (ALT) 45 units/L
• D. High-density lipoprotein (HDL) 75 mg/dL

Correct answer: A

Rationale: The correct answer is A. Troponin I is a specific marker for myocardial infarction, and levels of 8 ng/mL are elevated, indicating heart muscle damage. Brain natriuretic peptide (BNP) is more related to heart failure rather than myocardial infarction, making choice B incorrect. Alanine aminotransferase (ALT) is a liver enzyme and not specific to myocardial infarction, so choice C is incorrect. High-density lipoprotein (HDL) is a type of cholesterol and is not typically used to diagnose or monitor myocardial infarction, making choice D incorrect.

5. A client is being educated by a nurse on how to use a PCA pump postoperatively. Which statement by the client indicates understanding?

• A. I should wait until the pain is severe before using the PCA pump.
• B. My family can press the button for me while I’m asleep.
• C. I will press the button when I start to feel pain.
• D. I will only press the button once per hour.

Correct answer: C

Rationale: The correct answer is C. This statement indicates understanding because the client recognizes that they should use the PCA pump when they start to feel pain. Waiting for the pain to become severe is not recommended as it may lead to inadequate pain control. Option B is incorrect because only the client should control the PCA pump to ensure safety and appropriate dosing. Option D is also incorrect as there is no set limit on how often the button can be pressed, as it should be used as needed when pain is felt.

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