Nursing Elites

1. A healthcare provider is caring for a 4-year-old child who is resistant to taking medication. Which of the following strategies should the healthcare provider use to elicit the child's cooperation?

• A. Offer the child a choice of taking the medication with juice or water
• B. Tell the child it is candy
• C. Hide the medication in a large dish of ice cream
• D. Tell the child they will have a shot instead

Correct answer: A

Rationale: Offering children choices empowers them and can help in gaining cooperation, especially when it comes to taking medications. By providing options like taking the medication with juice or water, the child feels a sense of control and may be more willing to cooperate. This approach respects the child's autonomy and can make the experience more positive for both the child and the healthcare provider. Choices B, C, and D are not ideal strategies as they involve deception or coercion, which can lead to distrust and make the child more resistant to taking medication in the future.

2. What is the primary action of warfarin as an anticoagulant?

• A. Prevents the formation of blood clots
• B. Dissolves existing blood clots
• C. Dilates coronary arteries
• D. Treats rhythm disturbances

Correct answer: A

Rationale: The correct answer is A: "Prevents the formation of blood clots." Warfarin acts as an anticoagulant by inhibiting the synthesis of certain clotting factors in the liver. This action reduces the blood's ability to clot, making it effective in preventing the formation of blood clots. Choice B is incorrect because warfarin does not dissolve existing blood clots; it prevents their formation. Choice C is incorrect because warfarin's primary action is not to dilate coronary arteries. Choice D is incorrect as warfarin is not used to treat rhythm disturbances, but rather to prevent clot formation.

3. A client with Angina Pectoris asks the nurse about the next step if they take one tablet, wait 5 minutes, but still have Anginal pain. Which response should the nurse provide?

• A. Take two more sublingual tablets at the same time.
• B. Call emergency services.
• C. Take a sustained-release nitroglycerin capsule.
• D. Wait another 5 minutes then take a second sublingual tablet.

Correct answer: B

Rationale: If anginal pain persists after taking the first tablet and waiting 5 minutes, the priority step is to call emergency services (911) and then take a second sublingual tablet. Persistent pain could indicate a myocardial infarction, and immediate medical attention is crucial. Taking two more tablets at the same time (Choice A) can lead to excessive vasodilation and hypotension. Taking a sustained-release nitroglycerin capsule (Choice C) is not appropriate for immediate relief during an acute episode. Waiting another 5 minutes and then taking a second tablet (Choice D) is not advisable in this emergency situation where prompt action is necessary.

4. A client has a new prescription for Metronidazole to treat an infection. Which of the following instructions should the nurse include?

• A. Avoid alcohol while taking this medication.
• B. Take this medication on an empty stomach.
• C. Increase your intake of dairy products while taking this medication.
• D. Avoid direct sunlight while taking this medication.

Correct answer: A

Rationale: The correct instruction is to avoid alcohol while taking Metronidazole. This is crucial to prevent a disulfiram-like reaction, which can result in severe nausea and vomiting. Alcohol should be avoided for at least 48 hours after completing the medication course as well. Choice B is incorrect because Metronidazole can be taken with food to reduce gastrointestinal side effects. Choice C is incorrect because there is no need to increase dairy product intake while on Metronidazole. Choice D is incorrect because there is no specific instruction to avoid direct sunlight while taking this medication.

5. A healthcare professional is planning to administer subcutaneous enoxaparin 40 mg using a prefilled syringe of Enoxaparin 40 mg/0.4 mL to an adult client following hip arthroplasty. Which of the following actions should the healthcare professional plan to take?

• A. Expel the air bubble from the prefilled syringe before injecting.
• B. Insert the needle completely into the client's tissue.
• C. Administer the injection in the client's thigh.
• D. Aspirate carefully after inserting the needle into the client's skin.

Correct answer: B

Rationale: Correct Answer: B. When administering enoxaparin, it is essential to insert the needle completely into the client's tissue to ensure a deep subcutaneous injection. This method helps in the appropriate delivery of the medication. Choice A is incorrect because expelling air bubbles is not necessary with subcutaneous injections and may lead to medication loss. Choice C is incorrect as enoxaparin is usually administered in the abdomen, not the thigh. Choice D is incorrect as aspiration is not recommended for subcutaneous injections to avoid trauma or bleeding.

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