Nursing Elites

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

• A. Document the amount wasted
• B. Store it for later use
• C. Discard it with another nurse as a witness
• D. Return it to the pharmacy

Correct answer: C

Rationale: After administering a narcotic medication, any unused portion should be discarded with another nurse as a witness. This procedure ensures proper disposal of controlled substances and prevents misuse or diversion. Storing it for later use (Choice B) is not appropriate due to safety concerns and legal regulations. Returning it to the pharmacy (Choice D) is also not recommended as the medication is already out of the pharmacy's control. Documenting the amount wasted (Choice A) is important for accurate record-keeping but does not address the immediate need for safe disposal of the unused narcotic medication.

2. A nurse is updating a plan of care for a client who has dysphagia. What intervention should the nurse include?

• A. Encourage the client to lie down after eating
• B. Offer the client liquids with meals
• C. Have the client sit upright for 1 hour after meals
• D. Provide the client with a straw for drinking

Correct answer: C

Rationale: The correct intervention for a client with dysphagia is to have them sit upright for 1 hour after meals. This position helps facilitate swallowing and reduces the risk of aspiration, which is crucial in managing dysphagia. Encouraging the client to lie down after eating (Choice A) can increase the risk of aspiration. Offering liquids with meals (Choice B) may also increase the risk of aspiration as it can affect swallowing coordination. Providing the client with a straw for drinking (Choice D) is not recommended as straws can increase the risk of aspiration in individuals with dysphagia.

3. A nurse is caring for a client who reports a decrease in the effectiveness of their arthritis medication. What factor should the nurse identify as contributing to this decrease?

• A. Improved mobility
• B. Bowel inflammation
• C. Long-term use of the medication
• D. Frequent dehydration

Correct answer: B

Rationale: The correct answer is B: Bowel inflammation. Bowel inflammation can decrease the absorption of medications, reducing their effectiveness. Improved mobility (choice A) would generally not contribute to a decrease in medication effectiveness. Long-term use of the medication (choice C) may lead to tolerance but would not directly cause a decrease in effectiveness. Frequent dehydration (choice D) can affect overall health but is not a direct factor in the medication's effectiveness for arthritis.

4. A client with diabetes mellitus has a foot ulcer. What is an appropriate intervention to promote wound healing?

• A. Encourage a high-protein diet
• B. Apply a moisture-retentive dressing
• C. Provide daily wound irrigation
• D. Apply an ice pack to the wound

Correct answer: B

Rationale: The correct answer is to apply a moisture-retentive dressing. This promotes a moist wound environment, which is crucial for wound healing in clients with diabetes. Encouraging a high-protein diet may support overall health but is not directly related to wound healing. Daily wound irrigation can disrupt the wound healing process by removing necessary growth factors and cells. Applying an ice pack to the wound is contraindicated as it can impair circulation and delay wound healing.

5. A nurse is planning to administer multiple medications to a client with dysphagia. What action should the nurse take?

• A. Crush medications and mix them with honey
• B. Provide medications through a straw
• C. Place the medications in small amounts of pudding
• D. Offer the medications with a full glass of water

Correct answer: C

Rationale: The correct action for the nurse to take when administering medications to a client with dysphagia is to place the medications in small amounts of pudding. Mixing medications with pudding helps clients with dysphagia swallow them more easily. Choice A (crushing medications and mixing with honey) is not recommended as it may alter the medication properties. Choice B (providing medications through a straw) is not suitable for clients with dysphagia as it can pose a choking hazard. Choice D (offering medications with a full glass of water) may be difficult for clients with dysphagia to swallow and increase the risk of aspiration.

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