Nursing Elites

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

• A. Store it in the medication cart for later use
• B. Discard it with a witness present
• C. Return it to the pharmacy
• D. Report it to the provider

Correct answer: B

Rationale: The correct action for the nurse to take with the unused portion of a narcotic medication after administration is to discard it with a witness present. This procedure is necessary to comply with controlled substance regulations and prevent diversion or misuse of the medication. Storing it in the medication cart for later use is inappropriate as it can lead to unauthorized access. Returning it to the pharmacy is not recommended as the medication has already been dispensed. Reporting it to the provider is not the standard procedure for disposing of controlled substances.

2. A client is reviewing a medical record for advance directives. Which client statement indicates an understanding of the teaching?

• A. I don't need a living will because my family will make decisions.
• B. My living will takes effect only if I lose consciousness.
• C. My family will decide when to follow my living will.
• D. I can change my living will at any time.

Correct answer: D

Rationale: The correct answer is D because clients can change their living will at any time as long as they are mentally competent. Choice A is incorrect because relying solely on family to make decisions may not align with the client's wishes. Choice B is incorrect because a living will can address various situations, not just loss of consciousness. Choice C is incorrect because the client should be the primary decision-maker regarding their living will, not the family.

3. A client has a new prescription for a metered-dose inhaler (MDI). What instruction should the nurse include?

• A. Inhale the medication for 1 second
• B. Shake the inhaler vigorously before use
• C. Hold the inhaler 1-2 inches from the mouth
• D. Exhale immediately after inhalation

Correct answer: C

Rationale: The correct instruction for a client using a metered-dose inhaler (MDI) is to hold the inhaler 1-2 inches from the mouth. This distance allows for the proper delivery of the medication into the lungs. Choice A is incorrect because the duration of inhalation can vary depending on the medication, and 1 second may not be adequate. Choice B is incorrect as shaking the inhaler vigorously is not necessary for all MDIs and can lead to inaccurate dosing. Choice D is incorrect as the client should hold their breath for about 10 seconds after inhalation to allow the medication to deposit in the lungs.

4. When providing discharge teaching to a client prescribed home oxygen therapy, what information should the nurse include?

• A. Increase the oxygen flow rate during activity
• B. Avoid smoking and open flames near oxygen
• C. Store the oxygen tank in a warm, dry place
• D. Turn off the oxygen when not in use

Correct answer: B

Rationale: The correct answer is B: 'Avoid smoking and open flames near oxygen.' This information is crucial to prevent fire hazards when using home oxygen therapy. Smoking and open flames near oxygen can lead to serious accidents. Choice A is incorrect because increasing the oxygen flow rate during activity without healthcare provider guidance can be dangerous. Choice C is incorrect as oxygen tanks should be stored in a well-ventilated area, not necessarily warm and dry. Choice D is incorrect as oxygen should not be turned off and on by the client, as it can affect the therapy's effectiveness and cause safety issues.

5. A nurse is preparing to perform a sterile dressing change for a client who has a surgical wound. What should the nurse do to prevent contamination?

• A. Wear non-sterile gloves
• B. Apply sterile gloves over non-sterile gloves
• C. Change gloves if the sterile solution splashes onto the sterile field
• D. Cover the sterile field with a sterile drape

Correct answer: C

Rationale: The correct answer is C. If sterile solution splashes onto the sterile field, it is considered contaminated. Changing gloves in this situation ensures that the sterility of the dressing change is maintained. Choice A is incorrect as non-sterile gloves would introduce contaminants. Choice B is incorrect as layering gloves can increase the risk of contamination. Choice D is incorrect as covering the sterile field with a sterile drape is not the appropriate action to take in response to contamination.

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