Nursing Elites

1. When admitting a client with meningococcal meningitis, what should the nurse do first?

• A. Administer antibiotics
• B. Place the client on droplet precautions
• C. Perform a lumbar puncture
• D. Initiate seizure precautions

Correct answer: B

Rationale: When admitting a client with meningococcal meningitis, the nurse's priority should be to place the client on droplet precautions. This is crucial to prevent the spread of the infection to others. Administering antibiotics, performing a lumbar puncture, and initiating seizure precautions are important interventions but should come after implementing droplet precautions to ensure the safety of both the client and others.

2. A nurse is preparing to administer a medication to a client with a nasogastric (NG) tube. What action should the nurse take?

• A. Administer the medication with a straw
• B. Flush the NG tube with 30 mL of water before administration
• C. Crush all medications together
• D. Mix the medication with pudding

Correct answer: B

Rationale: The correct action for the nurse to take when administering medication to a client with a nasogastric (NG) tube is to flush the NG tube with 30 mL of water before administration. Flushing the tube with water helps ensure the patency of the tube and prevents clogging. Choice A is incorrect because administering the medication with a straw is not a recommended practice for NG tube administration. Choice C is incorrect because crushing all medications together may lead to potential drug interactions. Choice D is incorrect because mixing the medication with pudding is not a standard method for administering medication through an NG tube.

3. A client expresses anxiety about an upcoming surgery. What should the nurse do?

• A. Administer a sedative
• B. Ask the client to describe their feelings
• C. Call the surgeon to address the anxiety
• D. Provide information on post-op care

Correct answer: B

Rationale: When a client expresses anxiety, it is essential for the nurse to encourage the client to verbalize their feelings. This helps the client express concerns, fears, and uncertainties, enabling the nurse to provide appropriate emotional support. Administering a sedative (Choice A) should not be the initial response as it does not address the underlying emotional needs of the client. Calling the surgeon to address anxiety (Choice C) may not be within the nurse's scope of practice and may not directly address the client's emotional needs. Providing information on post-op care (Choice D) is important but not the priority when the client is experiencing anxiety preoperatively.

4. A nurse is preparing to administer medications to a client through a nasogastric (NG) tube. Which action should the nurse take?

• A. Crush all the medications and mix them together in water
• B. Flush the NG tube with 10 mL of air before each medication
• C. Dissolve each medication separately and flush with water between medications
• D. Administer all medications at the same time

Correct answer: C

Rationale: The correct action for the nurse to take when administering medications through an NG tube is to dissolve each medication separately and flush with water between medications. This practice helps prevent interactions between medications and ensures that each medication is delivered effectively. Option A is incorrect as mixing all medications together can lead to chemical interactions or alter the effectiveness of the medications. Option B is incorrect because flushing the NG tube with air is not recommended and may cause harm. Option D is incorrect as administering all medications at the same time does not allow for proper absorption and interaction control.

5. A client with chronic obstructive pulmonary disease (COPD) is being taught breathing exercises by a nurse. What instruction should the nurse include to improve oxygenation?

• A. Use pursed-lip breathing during activities
• B. Use deep breathing exercises after meals
• C. Perform diaphragmatic breathing during exercise
• D. Breathe in short, shallow breaths

Correct answer: A

Rationale: The correct instruction the nurse should include to improve oxygenation for a client with COPD is to 'Use pursed-lip breathing during activities.' Pursed-lip breathing helps improve oxygenation by slowing down the respiratory rate, reducing the work of breathing, and keeping the airways open. This technique also helps prevent the collapse of small airways during exhalation, allowing for more complete emptying of the lungs. Choices B, C, and D are incorrect because deep breathing exercises after meals, diaphragmatic breathing during exercise, and breathing in short, shallow breaths do not specifically target the improvement of oxygenation in individuals with COPD.

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