Nursing Elites

1. A nurse is caring for a client who has an altered mental status and has become aggressive. Which of the following prescriptions should the nurse clarify with the provider prior to administration?

• A. Haloperidol
• B. Zolpidem
• C. Morphine
• D. Lorazepam

Correct answer: B

Rationale: The correct answer is B: Zolpidem. Zolpidem is a sedative-hypnotic medication that can worsen altered mental status, especially in clients who are already aggressive. Therefore, the nurse should clarify this prescription with the provider before administration to ensure it is safe for the client. Choice A, Haloperidol, is an antipsychotic commonly used to manage aggression in clients with altered mental status, making it an appropriate choice in this scenario. Choice C, Morphine, is an opioid analgesic and would not directly impact the client's altered mental status or aggression. Choice D, Lorazepam, is a benzodiazepine used to manage anxiety and agitation, which could be beneficial in this situation but does not have the same potential to exacerbate altered mental status as Zolpidem.

2. When caring for the client diagnosed with delirium, which condition is the most important for the nurse to investigate?

• A. Cancer of any type
• B. Impaired hearing
• C. Prescription drug intoxication
• D. Heart failure

Correct answer: C

Rationale: When caring for a client diagnosed with delirium, the most important condition for the nurse to investigate is prescription drug intoxication. Delirium in older adults is commonly caused by medication side effects or interactions. Investigating prescription drug intoxication is crucial as it can be a reversible cause of delirium. While cancer, impaired hearing, and heart failure are important considerations in overall care, prescription drug intoxication takes precedence in cases of delirium.

3. A nurse is caring for a client who is 2 hours postoperative following an appendectomy. Which of the following findings should the nurse report to the provider?

• A. Urine output of 20 mL/hr.
• B. Temperature of 36.5°C (97.7°F).
• C. Sanguineous drainage on the surgical dressing.
• D. WBC count of 9,000/mm3.

Correct answer: A

Rationale: The correct answer is A: Urine output of 20 mL/hr. A urine output less than 30 mL/hr can indicate decreased renal perfusion, potentially due to hypovolemia or other issues, and should be reported to the provider. B: A temperature of 36.5°C (97.7°F) falls within the normal range and does not require immediate reporting. C: Sanguineous drainage on the surgical dressing is expected in the early postoperative period and should be monitored but does not need immediate reporting unless excessive. D: A WBC count of 9,000/mm3 is within the normal range and does not indicate an immediate concern.

4. What is the role of a nurse in managing a patient with kidney disease?

• A. Monitor blood pressure and provide dietary education
• B. Monitor urine output and provide IV fluids
• C. Administer diuretics and restrict fluid intake
• D. Monitor for cardiac arrhythmias and provide dialysis

Correct answer: A

Rationale: The correct answer is A. Nurses play a crucial role in managing patients with kidney disease by monitoring blood pressure and providing essential dietary education. This helps in maintaining kidney function and overall health. Choice B is incorrect because monitoring urine output and providing IV fluids are tasks usually performed by healthcare providers such as physicians or specialized staff. Choice C is incorrect as administering diuretics and restricting fluid intake are typically prescribed by a physician, and nurses may assist in monitoring the effects. Choice D is incorrect as monitoring for cardiac arrhythmias and providing dialysis are tasks that are usually overseen by healthcare providers with specialized training in cardiology and nephrology.

5. A public health nurse working in a rural area is developing a program to improve health for the local population. Which of the following actions should the nurse plan to take?

• A. Provide anticipatory guidance classes to parents through public schools.
• B. Have a nurse from outside the community provide health lectures at the county hospital.
• C. Encourage rural residents to focus health spending on tertiary health interventions.
• D. Launch a media campaign to increase awareness about industrial pollution.

Correct answer: A

Rationale: Providing anticipatory guidance classes to parents through public schools is the most appropriate action for the public health nurse in a rural area. This approach allows the nurse to address early prevention strategies, which are crucial in promoting health in rural populations. Choice B is incorrect because having a nurse from outside the community may not fully understand the local needs and dynamics. Choice C is wrong as focusing health spending on tertiary interventions is not cost-effective or preventive. Choice D is also incorrect because while increasing awareness about industrial pollution is important, it may not directly address the health needs of the local rural population.

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