Nursing Elites

1. A nurse in a clinic is caring for a client who has a urinary tract infection (UTI). Which of the following prescriptions should the nurse verify with a provider?

• A. Trimethoprim-sulfamethoxazole
• B. Hyoscyamine
• C. Oxybutynin
• D. Phenazopyridine

Correct answer: C

Rationale: The correct answer is C, Oxybutynin. Oxybutynin can worsen urinary retention, so the nurse should verify this prescription with the provider. Trimethoprim-sulfamethoxazole (Choice A) is a common antibiotic used to treat UTIs and does not require verification. Hyoscyamine (Choice B) is an anticholinergic medication used for bladder spasms and does not typically worsen UTI symptoms. Phenazopyridine (Choice D) is a urinary analgesic that helps relieve pain, burning, and discomfort caused by a UTI, which may not necessarily require verification in this scenario.

2. A nurse is receiving change-of-shift report on a group of clients. Which of the following clients should the nurse assess first?

• A. A client who has urolithiasis and reports severe ankle pain extending toward the abdomen
• B. A client who has acute cholecystitis and reports abdominal pain radiating to the right shoulder
• C. A client who has had a total knee arthroplasty, is 1 day postoperative, and reports a pain level of 8 on a 0 to 10 pain scale
• D. A client who has a fractured femur and reports sudden sharp chest pain

Correct answer: D

Rationale: The correct answer is D because a client with a fractured femur and sudden chest pain may be experiencing a pulmonary embolism, which requires immediate assessment. Choice A is incorrect because although severe pain is present, it is more indicative of musculoskeletal issues related to urolithiasis rather than a life-threatening condition. Choice B, related to acute cholecystitis, is less urgent than choice D as the pain radiating to the right shoulder is a common symptom but does not indicate an immediate life-threatening situation. Choice C, regarding a client post-total knee arthroplasty with a pain level of 8, is important but not as urgent as a potential pulmonary embolism in choice D.

3. When a patient refuses to remove their religious jewelry before surgery, what is the best response for the nurse preparing for the procedure?

• A. Proceed with the surgery and document the refusal.
• B. Ask the patient for permission to secure the jewelry safely.
• C. Tape the jewelry to the patient's body during surgery.
• D. Tell the patient they must remove the jewelry for safety reasons.

Correct answer: B

Rationale: The best response for the nurse is to ask the patient for permission to secure the jewelry safely. Hospital policy typically requires jewelry to be secured or removed to prevent interference during surgery. Proceeding with the surgery without addressing the issue or taping the jewelry to the patient's body are not safe practices and can lead to complications during the procedure. Directing the patient to remove the jewelry without exploring alternative solutions is not patient-centered care and may create unnecessary tension.

4. How does a healthcare professional assess a patient's fluid balance, and what signs indicate fluid overload?

• A. Checking lung sounds for crackles
• B. Checking for signs of orthopnea
• C. Monitoring intake and output, and checking for edema
• D. Measuring daily weight

Correct answer: C

Rationale: The correct answer is monitoring intake and output and checking for edema. Monitoring intake and output provides information about fluid balance in the body, while checking for edema helps assess for fluid overload. Lung sounds and signs of orthopnea are more indicative of respiratory issues rather than fluid balance. Daily weight measurement is useful to assess fluid status, but it alone may not provide a comprehensive evaluation of fluid balance.

5. The nurse is performing hand hygiene before assisting a healthcare provider with insertion of a chest tube. While washing hands, the nurse touches the sink. Which action will the nurse take next?

• A. Repeat handwashing using antiseptic soap.
• B. Inform the healthcare provider and recruit another nurse to assist.
• C. Extend the handwashing procedure to 5 minutes.
• D. Rinse and dry hands and begin assisting the healthcare provider.

Correct answer: A

Rationale: The correct answer is A. The sink is considered a contaminated area. When hand hygiene is compromised during the process, it is essential to repeat handwashing using antiseptic soap to ensure proper hygiene. Choice B is incorrect because the situation can be managed by proper handwashing. Choice C is incorrect as extending the handwashing procedure to 5 minutes is not necessary in this scenario. Choice D is incorrect as the hands need to be properly cleaned before assisting the healthcare provider.

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