Nursing Elites

1. A nurse in a provider's office is reinforcing discharge teaching with a client who is postoperative following cataract removal from one eye. Which of the following instructions should the nurse include?

• A. Use eye drops to soothe dryness
• B. Avoid rubbing the eye
• C. Sleep on the side of the affected eye
• D. Avoid lying on the affected side

Correct answer: D

Rationale: After cataract surgery, it is essential to avoid lying on the affected side to reduce pressure and promote healing. Sleeping on the side of the affected eye (Choice C) may increase pressure on the eye, leading to complications. While using eye drops to soothe dryness (Choice A) is generally recommended postoperatively, it is not as crucial as avoiding pressure on the eye. Rubbing the eye (Choice B) should be avoided to prevent irritation and potential damage, but it is not as critical as avoiding pressure on the affected eye.

2. What are the signs and symptoms of opioid withdrawal, and how should they be managed?

• A. Nausea, sweating, and increased heart rate; manage with methadone
• B. Pain and restlessness; manage with naloxone
• C. Hallucinations and muscle cramps; manage with clonidine
• D. Severe vomiting and seizures; manage with benzodiazepines

Correct answer: A

Rationale: The signs and symptoms of opioid withdrawal include nausea, sweating, and increased heart rate. Methadone is commonly used to manage opioid withdrawal symptoms by alleviating them. Choice B, managing with naloxone, is incorrect as naloxone is primarily used for opioid overdose reversal, not withdrawal. Choice C, managing with clonidine, is incorrect as clonidine is used to manage some symptoms of withdrawal, such as anxiety, agitation, and hypertension, but not hallucinations. Choice D, managing with benzodiazepines, is incorrect as benzodiazepines are not typically used as first-line treatment for opioid withdrawal; they may be considered in specific cases but are not a standard approach.

3. A nurse is preparing to administer a rectal suppository to a school-age child. Which of the following actions should the nurse plan to take?

• A. Insert the suppository 1 cm into the rectum
• B. Insert the suppository 2 cm into the rectum
• C. Insert the suppository past the anal sphincters
• D. Insert the suppository using two fingers

Correct answer: C

Rationale: The correct answer is C: 'Insert the suppository past the anal sphincters.' When administering a rectal suppository, it is essential to insert it past the anal sphincters to ensure proper placement and absorption. Choices A and B are incorrect because the suppository should be inserted further than just 1 or 2 cm into the rectum to reach the optimal absorption site. Choice D is incorrect as using two fingers is not necessary and may cause discomfort to the child.

4. A client is prescribed simvastatin. Which instruction should the nurse provide during teaching?

• A. Take this medication in the morning.
• B. Avoid drinking grapefruit juice.
• C. Increase your intake of leafy green vegetables.
• D. Monitor your pulse daily while taking this medication.

Correct answer: B

Rationale: The correct answer is B: 'Avoid drinking grapefruit juice.' Grapefruit juice can increase the risk of toxicity when taken with simvastatin. Instructing the client to avoid grapefruit juice helps prevent this interaction. Choice A is incorrect because the timing of medication administration for simvastatin is usually in the evening. Choice C is unrelated to simvastatin therapy. Choice D is not necessary for monitoring while taking simvastatin.

5. What is the most important intervention for a patient experiencing respiratory distress?

• A. Administer oxygen
• B. Monitor airway patency
• C. Provide bronchodilators
• D. Call for assistance

Correct answer: A

Rationale: Administering oxygen is crucial in managing a patient experiencing respiratory distress. Oxygen therapy helps to improve oxygen levels in the blood, supporting vital organ functions. While monitoring airway patency is important, administering oxygen takes precedence in ensuring the patient receives an adequate oxygen supply. Providing bronchodilators may be beneficial in certain respiratory conditions, but the immediate priority in distress is to address oxygenation. Calling for assistance is essential, but the immediate intervention to support the patient's respiratory function is administering oxygen.

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