Nursing Elites

1. A nurse in a pediatric unit is preparing to administer medication to a child. What should the nurse do to ensure the correct dosage?

• A. Check the child's weight
• B. Verify the medication order with a pharmacist
• C. Consult the child's parents
• D. Double-check the dosage calculations with another nurse

Correct answer: D

Rationale: When administering medication to children, it is crucial to ensure the correct dosage to prevent dosing errors. Double-checking the dosage calculations with another nurse can help verify the accuracy of the prescribed dose, reducing the risk of medication errors. While checking the child's weight (Choice A) is important for dosage calculation, it alone may not ensure the correctness of the dosage. Verifying the medication order with a pharmacist (Choice B) is essential, but it may not directly address the accuracy of dosage calculations. Consulting the child's parents (Choice C) is not a standard practice for verifying medication dosages and should not be solely relied upon for ensuring the correct dosage.

2. The nurse is caring for a client with Myasthenia Gravis. What time of day is best for the nurse to schedule physical exercises with the physical therapy department?

• A. Before bedtime, at 2000
• B. After breakfast
• C. Before the evening meal
• D. After lunch

Correct answer: B

Rationale: Scheduling physical exercises after breakfast is the optimal choice for a client with Myasthenia Gravis. This timing allows the client to benefit from renewed energy levels after overnight rest and intake of morning nourishment, enhancing the effectiveness of the therapy session. Choices A (Before bedtime, at 2000) is not suitable as energy levels are likely lower at night, affecting the client's ability to engage effectively in physical exercises. Choices C (Before the evening meal) and D (After lunch) may not be ideal as the client may experience fatigue or weakness later in the day, making it harder to participate actively in therapy.

3. The nurse is caring for a client with a tracheostomy who is on mechanical ventilation. What is the priority nursing intervention?

• A. Suction the tracheostomy as needed
• B. Ensure the tracheostomy ties are secure
• C. Provide humidified oxygen
• D. Clean any exudate around the tracheostomy site

Correct answer: A

Rationale: The priority nursing intervention for a client with a tracheostomy on mechanical ventilation is to suction the tracheostomy as needed. Suctioning is essential to maintain a clear airway and prevent respiratory distress. While ensuring tracheostomy ties are secure (choice B) is important, it is not as urgent as airway maintenance. Providing humidified oxygen (choice C) is beneficial but does not address the immediate need for airway clearance. Cleaning exudate around the tracheostomy site (choice D) is important for hygiene but takes precedence over ensuring airway patency through suctioning.

4. A client with a history of seizure disorder who is receiving phenytoin (Dilantin) is being discharged. Which instruction should the nurse provide?

• A. Take the medication at bedtime.
• B. Monitor drug levels regularly.
• C. Avoid alcohol while taking this medication.
• D. Take the medication at the same time every day.

Correct answer: B

Rationale: The correct answer is to instruct the client to monitor drug levels regularly. This is crucial for phenytoin (Dilantin) to ensure that the medication levels are within the therapeutic range and to prevent toxicity. Choice A, taking the medication at bedtime, is not specifically required for phenytoin administration. Choice C, avoiding alcohol, is generally a good practice with medications but is not as critical as monitoring drug levels for phenytoin. Choice D, taking the medication at the same time every day, is important for consistency but does not address the specific monitoring needs of phenytoin.

5. A client with asthma is prescribed a corticosteroid inhaler. What instruction should the nurse give about the inhaler?

• A. Use it only during asthma attacks
• B. Rinse the mouth after each use to prevent oral thrush
• C. It will provide immediate relief during an asthma attack
• D. Increase the dose if breathing does not improve

Correct answer: B

Rationale: The correct instruction for a client using a corticosteroid inhaler is to rinse the mouth after each use to prevent the development of oral thrush, a common side effect of these inhalers. Choice A is incorrect as corticosteroid inhalers are often used regularly as a maintenance treatment, not just during asthma attacks. Choice C is incorrect because corticosteroid inhalers provide long-term control of asthma symptoms, not immediate relief during an attack. Choice D is incorrect and potentially dangerous advice as increasing the dose without medical guidance can lead to adverse effects.

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