Nursing Elites

1. A nurse in an outpatient surgical center is admitting a client for a laparoscopic procedure. The client has a prescription for preoperative diazepam. Prior to administering the medication, which of the following actions is the nurse’s priority?

• A. Teaching the client about the purpose of the medication
• B. Giving the medication at the administration time the provider prescribed
• C. Identifying the client’s medication allergies
• D. Documenting the client’s anxiety level

Correct answer: C

Rationale: The correct answer is C: Identifying the client's medication allergies. This is the priority action before administering any medication to prevent allergic reactions or adverse effects. Teaching the client about the medication's purpose is important for client understanding but not as critical as ensuring the absence of allergies. While giving medication at the prescribed time is crucial, verifying allergies takes precedence to ensure patient safety. Documenting the client's anxiety level is relevant for holistic care but is not the priority compared to ensuring safe medication administration.

2. A client who has a terminal illness asks several questions about the nurse's religious beliefs related to death and dying. Which of the following actions should the nurse take?

• A. Encourage the client to express their thoughts about death and dying
• B. Share the nurse's personal beliefs about death and dying
• C. Redirect the client to a chaplain or spiritual advisor
• D. Provide a brief overview of common religious beliefs about death and dying

Correct answer: A

Rationale: Encouraging the client to express their thoughts allows them to explore their own feelings and concerns about death. This approach empowers the client to reflect on their beliefs and values without the influence of the nurse's personal beliefs (choice B), which should remain separate in a professional setting. Redirecting the client to a chaplain or spiritual advisor (choice C) may be appropriate if the client seeks specific spiritual guidance. Providing a brief overview of common religious beliefs (choice D) may not address the client's individual questions and concerns.

3. While auscultating the anterior chest of a newly admitted patient, what would the nurse expect to hear?

• A. Normal breathing sounds
• B. Wheezing
• C. Crackles
• D. Stridor

Correct answer: A

Rationale: When auscultating the chest, normal breathing sounds are expected in a healthy individual. Wheezing is a high-pitched whistling sound that indicates narrowed airways and is often heard in conditions like asthma. Crackles are fine, crackling sounds heard on inspiration or expiration and are associated with conditions like pneumonia or heart failure. Stridor is a high-pitched, harsh sound heard during inspiration due to upper airway obstruction. Therefore, choices B, C, and D indicate abnormal respiratory findings, while choice A signifies normal breathing sounds.

4. What is the first step a healthcare professional should take when preparing to provide tracheostomy care?

• A. Perform hand hygiene
• B. Gather equipment
• C. Explain the procedure
• D. Assess the client

Correct answer: A

Rationale: Performing hand hygiene is the initial step a healthcare professional should take when preparing to provide tracheostomy care. This step is crucial to prevent the transmission of pathogens and reduce the risk of infection to the client. By cleansing the hands, the healthcare professional ensures patient safety. While gathering equipment, explaining the procedure, and assessing the client are essential components of tracheostomy care, they should occur after performing hand hygiene to maintain aseptic technique and minimize the risk of introducing harmful microorganisms to the client.

5. A healthcare professional is preparing to administer gentamicin 2 mg/kg via IV bolus to a client who weighs 220 lb. How many mg should the healthcare professional administer?

• A. 200 mg
• B. 100 mg
• C. 160 mg
• D. 180 mg

Correct answer: C

Rationale: To calculate the dosage correctly, the weight in pounds must first be converted to kilograms. 220 lb / 2.2 = 100 kg. Then, multiply the weight in kg by the dosage of 2 mg/kg: 2 mg/kg × 100 kg = 200 mg. Therefore, the correct dosage to administer is 200 mg, which is closest to option A. Option C (160 mg) is incorrect because it does not match the calculated dosage. Options B (100 mg) and D (180 mg) are also incorrect as they do not align with the correct calculation.

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