Nursing Elites

1. When caring for a client with a prescription for wound irrigation, which action should the nurse take?

• A. Use a 10-mL syringe with an 18-gauge needle.
• B. Cleanse the wound from the center outward.
• C. Apply a wet-to-dry dressing.
• D. Pack the wound tightly with gauze.

Correct answer: B

Rationale: When caring for a client with a prescription for wound irrigation, the nurse should cleanse the wound from the center outward. This technique helps prevent the introduction of microorganisms into the wound, reducing the risk of contamination and promoting effective wound healing. By using a circular motion from the cleanest area to the least clean areas, debris and bacteria are moved away from the wound site, decreasing the chances of infection.

2. A healthcare provider is caring for a client who is receiving IV therapy via a peripheral catheter. The healthcare provider should identify that which of the following findings is an indication of infiltration?

• A. Redness at the infusion site
• B. Edema at the infusion site
• C. Warmth at the infusion site
• D. Oozing of blood at the infusion site

Correct answer: B

Rationale: Edema at the infusion site is an indication of infiltration, where fluid leaks into the surrounding tissues causing swelling. This can compromise the delivery of medication and fluids, potentially leading to complications. Redness, warmth, and oozing of blood are more suggestive of inflammation or infection rather than infiltration. Infiltration requires prompt recognition and intervention to prevent further issues with the IV therapy.

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

• A. Use a tuberculin syringe.
• B. Insert the needle at a 45-degree angle.
• C. Use a 1-inch needle.
• D. Aspirate before injecting.

Correct answer: A

Rationale: When administering an intradermal injection, a tuberculin syringe is the appropriate choice due to its small size and precise measurement markings, which are essential for accurately delivering the medication into the dermis layer of the skin. Using a 1-inch needle (choice C) is more common for subcutaneous injections, while inserting the needle at a 45-degree angle (choice B) is typical for intramuscular injections. Aspirating before injecting (choice D) is not necessary for intradermal injections, as the goal is to deliver the medication into the dermis rather than a blood vessel.

4. During discharge instructions, a client with a new prescription for a metered-dose inhaler (MDI) states, 'I will shake the inhaler before each use.' Which of the following client statements indicates an understanding of the teaching?

• A. I will shake the inhaler before each use.
• B. I will use the inhaler immediately after meals.
• C. I will inhale the medication quickly.
• D. I will clean the mouthpiece with alcohol.

Correct answer: A

Rationale: The correct answer is A because shaking the inhaler before each use ensures that the medication is properly mixed, which is essential for effective administration. This action helps to disperse the medication evenly, enhancing its efficacy when inhaled. Proper mixing through shaking prevents inconsistent dosing and ensures that the client receives the correct amount of medication with each use.

5. When providing teaching to a client with a new prescription for digoxin, which of the following instructions should the nurse include?

• A. Take your pulse before taking the medication.
• B. Take the medication with an antacid.
• C. Double the dose if you miss one.
• D. Take the medication with a high-fiber meal.

Correct answer: A

Rationale: The correct instruction for a client with a new prescription for digoxin is to take their pulse before taking the medication. Digoxin can lead to bradycardia as a side effect, and monitoring the pulse helps in assessing the heart rate prior to medication administration. This precaution allows for the identification of any significant changes in heart rate that may require medical attention.

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