Nursing Elites

1. A nurse is caring for a client who has a prescription for a narcotic medication. After administering, the nurse is left with an unused portion. What should the nurse do?

• A. Store the unused medication for later use
• B. Discard the medication in a regular trash bin
• C. Discard the medication with another nurse as a witness
• D. Report the unused portion to the provider

Correct answer: C

Rationale: The correct answer is to discard the medication with another nurse as a witness. Controlled substances, such as narcotic medications, must be properly disposed of to prevent misuse or diversion. Having another nurse witness the disposal ensures accountability and follows proper protocols. Storing the unused medication for later use (Choice A) is unsafe and could lead to misuse. Discarding the medication in a regular trash bin (Choice B) is inappropriate as it does not ensure proper disposal of a controlled substance. Reporting the unused portion to the provider (Choice D) is not the immediate action needed for proper medication disposal.

2. A nurse is caring for a client who reports burning around the peripheral IV site. Which finding should the nurse identify as a manifestation of infiltration?

• A. Redness at the site
• B. Warmth around the site
• C. Edema
• D. Pain at the site

Correct answer: C

Rationale: Edema at the IV site indicates that IV solution has leaked into the extravascular tissue, which is a sign of infiltration. Redness, warmth, and pain at the site are more indicative of phlebitis, not infiltration. Phlebitis is characterized by redness, warmth, and pain along the vein where the IV is placed, while infiltration involves the leaking of IV fluids into the surrounding tissue.

3. A nurse is preparing to administer a dose of iron supplement. Which of the following should the nurse do?

• A. Give it with milk
• B. Administer it on an empty stomach
• C. Check blood pressure
• D. Monitor for allergic reactions

Correct answer: B

Rationale: The correct answer is B: Administer it on an empty stomach. Iron supplements are best absorbed on an empty stomach to enhance their absorption. It is important to avoid giving them with milk or dairy products as these can inhibit iron absorption. Checking blood pressure and monitoring for allergic reactions are not directly related to the administration of iron supplements and are not the primary considerations in this case.

4. A nurse is reviewing the laboratory results for a client who has a prescription for filgrastim. The nurse should recognize that an increase in which of the following values indicates a therapeutic effect of this medication?

• A. Erythrocyte count
• B. Neutrophil count
• C. Lymphocyte count
• D. Thrombocyte count

Correct answer: B

Rationale: Filgrastim is used to increase neutrophil production in clients undergoing chemotherapy or with bone marrow suppression. A rise in neutrophil count indicates the medication is working effectively to boost immune response. Choices A, C, and D are incorrect as filgrastim primarily targets neutrophils, not erythrocytes, lymphocytes, or thrombocytes.

5. A nurse is caring for a group of clients. Which of the following clients should the nurse assign to an assistive personnel (AP)?

• A. Client who has chronic obstructive pulmonary disease and needs guidance with incentive spirometry
• B. Client who has awoken following a bronchoscopy and requests a drink
• C. Client who had a myocardial infarction 3 days ago and reports chest discomfort
• D. Client who had a cerebrovascular accident 2 days ago and needs help toileting

Correct answer: D

Rationale: The correct answer is D because the client who had a cerebrovascular accident 2 days ago and needs help toileting is stable and the task is appropriate for delegation to an assistive personnel (AP). Choices A, B, and C involve clients with more complex care needs that require the expertise of a nurse. Choice A involves providing guidance with incentive spirometry, which requires specialized knowledge and assessment skills. Choice B involves a client who has just undergone a bronchoscopy, so close monitoring is essential to assess for any complications. Choice C involves a client who had a myocardial infarction 3 days ago and is reporting chest discomfort, which could indicate a potential cardiac issue requiring immediate nursing assessment and intervention.

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