Nursing Elites

1. A nurse is caring for a client who has end-stage osteoporosis and is reporting severe pain. The client’s respiratory rate is 14 per minute. Which of the following medications should the nurse prioritize administering?

• A. Promethazine
• B. Hydromorphone
• C. Ketorolac
• D. Amitriptyline

Correct answer: B

Rationale: Hydromorphone, an opioid, is the most appropriate option for managing severe pain in this context. Opioids provide fast-acting relief for acute pain associated with advanced osteoporosis. Promethazine (Choice A) is an antihistamine and not indicated for pain relief. Ketorolac (Choice C) is a nonsteroidal anti-inflammatory drug (NSAID) that may increase the risk of bleeding and is not recommended for severe pain management. Amitriptyline (Choice D) is a tricyclic antidepressant that is not the first-line treatment for severe acute pain.

2. A client is at high risk for iron deficiency anemia. Which of the following foods should the nurse instruct the client to increase in their diet?

• A. Yogurt
• B. Apples
• C. Raisins
• D. Cheddar cheese

Correct answer: C

Rationale: The correct answer is C: Raisins. Raisins are a good source of iron, which can help prevent or address iron deficiency anemia. Yogurt (Choice A) and cheddar cheese (Choice D) are not significant sources of iron. While apples (Choice B) are a healthy fruit, they do not contain as much iron as raisins.

3. A client who is 2 hours postpartum reports heavy bleeding and passing large clots. What is the nurse's priority action?

• A. Perform fundal massage
• B. Administer oxytocin IV
• C. Check vital signs
• D. Encourage the client to void

Correct answer: A

Rationale: The correct answer is A: Perform fundal massage. Fundal massage promotes uterine contractions, which is the initial action to reduce postpartum hemorrhage caused by uterine atony. Checking vital signs (choice C) is important but not the priority when active bleeding is present. Administering oxytocin IV (choice B) may be needed but is not the priority action. Encouraging the client to void (choice D) does not address the underlying issue of postpartum hemorrhage and should not be the priority.

4. A nurse is caring for a client who has a prescription for a narcotic medication. After administering, the nurse is left with an unused portion. What should the nurse do?

• A. Store the unused medication for later use
• B. Discard the medication in a regular trash bin
• C. Discard the medication with another nurse as a witness
• D. Report the unused portion to the provider

Correct answer: C

Rationale: The correct answer is to discard the medication with another nurse as a witness. Controlled substances, such as narcotic medications, must be properly disposed of to prevent misuse or diversion. Having another nurse witness the disposal ensures accountability and follows proper protocols. Storing the unused medication for later use (Choice A) is unsafe and could lead to misuse. Discarding the medication in a regular trash bin (Choice B) is inappropriate as it does not ensure proper disposal of a controlled substance. Reporting the unused portion to the provider (Choice D) is not the immediate action needed for proper medication disposal.

5. A nurse is teaching a client who has hypertension about dietary modifications to help control blood pressure. Which of the following food choices should the nurse recommend as the best choice for the client to include in their diet?

• A. 1 packet of reconstituted dry onion soup
• B. 3 oz of lean cured ham
• C. 3 oz of chicken breast
• D. 1/2 cup of canned baked beans

Correct answer: C

Rationale: A low sodium diet is recommended for a client who has hypertension. Therefore, the nurse should recommend 3 oz of chicken breast as the best choice for the client's diet because it contains 30 – 90 mg of sodium. Choice A, 1 packet of reconstituted dry onion soup, and Choice B, 3 oz of lean cured ham, are high in sodium content, which is not suitable for a client with hypertension. Choice D, 1/2 cup of canned baked beans, is also high in sodium, making it a less suitable choice compared to 3 oz of chicken breast.

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