Nursing Elites

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

• A. Discard the medication in the trash
• B. Return the medication to the pharmacy
• C. Discard the medication with another nurse as a witness
• D. Store the medication for future use

Correct answer: C

Rationale: The correct action for the nurse to take when left with an unused portion of a narcotic medication is to discard the medication with another nurse as a witness. This procedure ensures accountability and proper disposal of controlled substances. Choice A is incorrect as discarding in the trash can lead to potential misuse or environmental harm. Choice B is incorrect because returning controlled substances to the pharmacy is not the appropriate method for disposal. Choice D is incorrect as storing the medication for future use is not permitted with controlled substances.

2. A client with a permanent spinal cord injury is scheduled for discharge. Which of the following client statements indicates that the client is coping effectively?

• A. “I would like to play wheelchair basketball. When I get stronger, I think I’ll look for a league.”
• B. “I’m glad I’ll only be in this wheelchair temporarily. I can’t wait to get back to running.”
• C. “I’m so upset that this happened to me. What did I do to deserve this, and why am I not getting better?”
• D. “I feel like I’ll never be able to do anything that I want to again. All I am is a burden to my family.”

Correct answer: A

Rationale: Choice A is the correct answer. This statement demonstrates effective coping as the client is showing acceptance of their disability and planning for the future with realistic goals. Choice B reflects denial of the permanent disability by stating that they will only be in a wheelchair temporarily. Choice C shows distress and a lack of acceptance by questioning why the injury happened and why they are not improving. Choice D indicates feelings of hopelessness and being a burden, which are not signs of effective coping.

3. A client presents with symptoms suggestive of rheumatoid arthritis. Which of the following laboratory tests should be ordered to confirm this diagnosis?

• A. Erythrocyte sedimentation rate (ESR)
• B. Rheumatoid factor
• C. Antinuclear antibody
• D. Serum calcium

Correct answer: B

Rationale: Rheumatoid factor is a specific marker for rheumatoid arthritis. It is often elevated in clients with this autoimmune condition, helping to confirm the diagnosis. Erythrocyte sedimentation rate (ESR) and antinuclear antibody tests can be supportive but are not specific for rheumatoid arthritis. Serum calcium levels are not typically used to confirm this diagnosis.

4. A healthcare professional is assessing the pain level of a client who has dementia and difficulty communicating. Which pain assessment technique should the healthcare professional use?

• A. Numeric rating scale
• B. Behavioral indicators
• C. Visual analog scale
• D. Faces pain scale

Correct answer: B

Rationale: For clients with dementia who have difficulty communicating, assessing pain using behavioral indicators like increased agitation and restlessness is more effective than relying on self-reported scales such as numeric rating scale, visual analog scale, or faces pain scale. Behavioral indicators provide valuable insights into pain perception in individuals who may have challenges expressing themselves verbally.

5. A nurse is caring for a client with a new prescription for atorvastatin. Which of the following should the nurse monitor?

• A. Liver function tests
• B. Potassium levels
• C. Blood glucose levels
• D. Serum calcium levels

Correct answer: A

Rationale: The correct answer is A: Liver function tests. Atorvastatin, a medication commonly used to lower cholesterol levels, can potentially cause liver damage as a side effect. Monitoring liver function tests is essential to detect any abnormalities early. Choices B, C, and D are incorrect because atorvastatin is not known to directly impact potassium levels, blood glucose levels, or serum calcium levels. While these parameters may be monitored for other reasons, the priority when administering atorvastatin is to monitor liver function due to the risk of hepatotoxicity.

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