Nursing Elites

1. A nurse is caring for a client who has acute pancreatitis. Which of the following interventions should the nurse take?

• A. Encourage oral intake of clear liquids
• B. Administer an antiemetic before meals
• C. Insert a nasogastric tube for suction
• D. Place the client in a supine position

Correct answer: C

Rationale: In acute pancreatitis, the gastrointestinal tract needs to rest to reduce pancreatic enzyme secretion. Inserting a nasogastric tube for suction helps decompress the stomach and reduce stimulation of the pancreas. Encouraging oral intake of clear liquids (Choice A) or administering an antiemetic before meals (Choice B) may aggravate the condition by stimulating the pancreas. Placing the client in a supine position (Choice D) may not directly address the underlying issue of reducing pancreatic stimulation.

2. A nurse is providing teaching to a client who has a new prescription for clopidogrel. Which of the following instructions should the nurse include?

• A. Avoid eating foods high in potassium.
• B. Avoid drinking alcohol while taking this medication.
• C. Take this medication with a full glass of water.
• D. Take this medication with a full glass of water.

Correct answer: C

Rationale: The correct answer is C. Clients taking clopidogrel should take the medication with a full glass of water to prevent gastrointestinal irritation. Choice A is incorrect because there is no specific recommendation to avoid foods high in potassium with clopidogrel. Choice B is unrelated to the medication's administration. Choice D is a duplication of choice C, providing no additional information.

3. A patient is being cared for by a nurse who has a history of angina and is experiencing chest pain. Which of the following actions should the nurse take first?

• A. Administer oxygen at 2 L/min via nasal cannula.
• B. Administer nitroglycerin sublingually.
• C. Obtain a 12-lead ECG.
• D. Notify the healthcare provider.

Correct answer: C

Rationale: In a patient with a history of angina experiencing chest pain, the priority action for the nurse is to obtain a 12-lead ECG. This helps in assessing for myocardial infarction, a serious condition that requires immediate attention. Administering oxygen, nitroglycerin, or notifying the healthcare provider can be important interventions but obtaining the ECG comes first to determine the presence of myocardial infarction and guide further management.

4. How should a healthcare provider respond to a patient with a history of hypertension who is non-compliant with medication?

• A. Encourage compliance through education
• B. Contact the healthcare provider
• C. Document the refusal
• D. Explore alternative treatment options

Correct answer: A

Rationale: Encouraging compliance through education is crucial in helping patients understand the importance of consistent medication use. By providing education, the patient can make informed decisions about their health and better manage their condition. Contacting the healthcare provider (choice B) may be necessary in some cases, but the initial approach should focus on patient education. Documenting the refusal (choice C) is important for legal and medical records but does not address the root cause of non-compliance. Exploring alternative treatment options (choice D) should come after efforts to educate and encourage compliance with the current medication regimen.

5. A nurse is caring for an adult client who has prescriptions for multiple medications. Which of the following is an age-related change that increases the risk for adverse effects from these medications?

• A. Rapid gastric emptying
• B. Prolonged medication half-life
• C. Increased medication elimination
• D. Decreased medication sensitivity

Correct answer: B

Rationale: The correct answer is B: Prolonged medication half-life. As clients age, their metabolism tends to slow down, leading to a prolonged half-life of medications in the body. This extended presence of drugs can increase the risk for adverse effects as the substances accumulate. Choice A, rapid gastric emptying, is not an age-related change and actually decreases the time medications spend in the stomach, potentially reducing their effectiveness. Choice C, increased medication elimination, is not an age-related change either; in fact, aging can lead to decreased renal function, affecting drug elimination. Choice D, decreased medication sensitivity, is not an age-related change that directly increases the risk for adverse effects; rather, it may lead to requiring higher doses for effectiveness but does not inherently increase the risk of adverse effects.

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