Nursing Elites

1. A client is receiving vancomycin. Which of the following should the nurse monitor?

• A. Blood glucose levels
• B. Serum creatinine
• C. INR levels
• D. Liver function tests

Correct answer: B

Rationale: The correct answer is B: Serum creatinine. Vancomycin is known to be nephrotoxic, meaning it can cause kidney damage. Monitoring serum creatinine levels is essential to assess kidney function and detect any signs of nephrotoxicity. Blood glucose levels (choice A) are not directly affected by vancomycin. INR levels (choice C) are typically monitored for clients on anticoagulants, not vancomycin. Liver function tests (choice D) are not primarily affected by vancomycin use; kidney function is of greater concern.

2. Using Naegele's Rule, what is the estimated delivery date for a pregnant client whose last menstrual period was on May 4th, 2013?

• A. January 15, 2014
• B. February 11, 2014
• C. March 3, 2014
• D. December 25, 2013

Correct answer: B

Rationale: Naegele's rule is a standard method for calculating the estimated delivery date (EDD). It involves subtracting three months from the first day of the last menstrual period (LMP), adding seven days, and then adding one year. For a client with an LMP of May 4th, 2013, subtracting three months gives February 4th. Adding seven days results in a due date of February 11th, 2014, which is the correct answer. Choice A (January 15, 2014) is incorrect as it does not account for the full calculation. Choice C (March 3, 2014) is incorrect as it adds too many days in the calculation. Choice D (December 25, 2013) is incorrect as it does not follow the correct steps of Naegele's rule.

3. A healthcare professional is preparing to administer ceftriaxone. Which of the following actions should the healthcare professional take?

• A. Reconstitute the medication with normal saline
• B. Reconstitute the medication with sterile water
• C. Administer the medication over 30 minutes
• D. Monitor for signs of toxicity

Correct answer: B

Rationale: Correct Answer: B. Ceftriaxone should be reconstituted with sterile water, not saline. Reconstituting it with normal saline can result in a chemical interaction and precipitation of the drug. Administering the medication over 30 minutes (choice C) is not necessary as ceftriaxone is usually given as an intravenous bolus or drip over a shorter period. Monitoring for signs of toxicity (choice D) is important but not the immediate action required for preparing the medication. The priority is to ensure proper reconstitution with the appropriate solvent, which is sterile water.

4. A nurse is teaching a client with newly diagnosed hypertension about lifestyle changes. Which of the following recommendations should the nurse make?

• A. Limit sodium intake to 3,000 mg per day.
• B. Exercise for at least 30 minutes most days of the week.
• C. Drink no more than two alcoholic drinks per day.
• D. Increase fluid intake to at least 3 liters per day.

Correct answer: B

Rationale: The correct answer is B: 'Exercise for at least 30 minutes most days of the week.' Regular exercise, especially aerobic activity, is known to help lower blood pressure and should be included in lifestyle changes for managing hypertension. Choice A is incorrect because the recommended sodium intake for individuals with hypertension is usually lower than 3,000 mg per day. Choice C is incorrect as it is advisable to limit alcohol intake to one drink per day for women and two drinks per day for men. Choice D is incorrect because increasing fluid intake to 3 liters per day may not be necessary and could be harmful in some cases, depending on the individual's health status.

5. While assessing the IV infusion site of a client who reports pain at the site, a nurse notes redness and warmth along the vein. What should the nurse do?

• A. Continue the infusion
• B. Increase the infusion rate
• C. Discontinue the infusion
• D. Apply a cold compress

Correct answer: C

Rationale: The symptoms described indicate phlebitis, which is inflammation of the vein. In this case, the nurse should discontinue the infusion to prevent further complications. Continuing the infusion or increasing the rate can exacerbate the condition. Applying a cold compress is not recommended for phlebitis; instead, a warm compress can help alleviate discomfort.

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