Nursing Elites

1. A nurse in a provider's office is assessing a client who reports a decrease in the effectiveness of their arthritis medication. Which client information should the nurse identify as a contributing factor to the decrease in the medication's effectiveness?

• A. Taking the medication with water
• B. Skipping doses of medication
• C. A history of recurring bowel inflammation
• D. Taking anti-inflammatory medication without food

Correct answer: C

Rationale: The correct answer is C. A history of recurring bowel inflammation can impact the absorption and effectiveness of arthritis medication. Bowel inflammation can affect the body's ability to absorb the medication properly, leading to decreased effectiveness. Choices A, B, and D do not directly relate to the decreased effectiveness of the arthritis medication. Taking medication with water, skipping doses, or taking anti-inflammatory medication without food may not be ideal practices but are not directly linked to the decrease in effectiveness reported by the client.

2. A nurse is reviewing the medication class, benzodiazepines. The nurse would use caution when administering benzodiazepines to which of the clients below?

• A. A client with glaucoma
• B. A client with renal failure
• C. A client with hypertension
• D. A client with insomnia

Correct answer: A

Rationale: Benzodiazepines can increase intraocular pressure, which is why they must be used cautiously in patients with glaucoma. In clients with this condition, benzodiazepines can potentially worsen symptoms and lead to further complications involving the eyes. Therefore, administering benzodiazepines to a client with glaucoma should be done with caution. Choices B, C, and D are not directly contraindicated with benzodiazepines, making them less likely to cause harm compared to administering to a client with glaucoma.

3. A healthcare provider is providing dietary teaching to a client who has chronic kidney disease. Which of the following food choices should the healthcare provider recommend?

• A. A baked potato
• B. A chicken breast
• C. A banana
• D. A cup of orange juice

Correct answer: B

Rationale: The correct answer is B: A chicken breast. Chicken breast is low in potassium, making it a safe option for clients with chronic kidney disease who need to limit their potassium intake. Foods like bananas and orange juice are high in potassium, which should be avoided or limited by individuals with chronic kidney disease to prevent further kidney damage.

4. A nurse is caring for a client who sprained his ankle 12 hours ago. Which of the following provider prescriptions should the nurse question?

• A. Elevate the affected extremity on two pillows
• B. Apply heat to the affected extremity for 45 minutes
• C. Wrap the extremity with a compression dressing
• D. Assess sensation, movement, and pulse every 4 hours

Correct answer: B

Rationale: The nurse should question the prescription to apply heat to the affected extremity for 45 minutes. Heat should not be applied in the first 48 hours after an acute injury, as it can increase swelling. Cold therapy is more appropriate initially. Choices A, C, and D are appropriate actions in the care of a client with a sprained ankle. Elevating the affected extremity helps reduce swelling, wrapping it with a compression dressing provides support, and assessing sensation, movement, and pulse every 4 hours is important to monitor for complications.

5. A client has been prescribed phenytoin. Which of the following should the nurse monitor to prevent toxicity?

• A. Blood pressure
• B. Complete blood count
• C. Serum phenytoin levels
• D. Liver function tests

Correct answer: C

Rationale: Corrected Rationale: Serum phenytoin levels should be regularly monitored to prevent toxicity because the therapeutic range is narrow. Monitoring blood pressure (choice A), complete blood count (choice B), and liver function tests (choice D) are not directly related to preventing phenytoin toxicity.

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