Nursing Elites

1. A client is experiencing a seizure. Which of the following interventions should the nurse implement?

• A. Place a tongue depressor in the client's mouth
• B. Loosen tight clothing around the client
• C. Restrain the client's arms and legs
• D. Administer 100% oxygen via non-rebreather mask

Correct answer: B

Rationale: During a seizure, it is essential to loosen tight clothing around the client to prevent injury and promote adequate ventilation. Placing any objects, like a tongue depressor, in the client's mouth can lead to airway obstruction or injury. Restraining the client's arms and legs can exacerbate the situation by increasing muscle rigidity and potentially causing injury. Administering oxygen via a non-rebreather mask is not typically indicated during a seizure unless respiratory distress is present.

2. What is the primary purpose of administering an antiemetic?

• A. To reduce nausea and vomiting
• B. To increase appetite
• C. To treat nausea caused by chemotherapy
• D. To treat allergic reactions

Correct answer: A

Rationale: The correct answer is A: 'To reduce nausea and vomiting.' Antiemetics are medications used to prevent or alleviate nausea and vomiting. While they may indirectly help with appetite by reducing the unpleasant symptoms that can lead to decreased food intake, their primary purpose is not to increase appetite (Choice B). Choice C, 'To treat nausea caused by chemotherapy,' is partly correct as antiemetics are commonly used to manage chemotherapy-induced nausea, but this is not their exclusive purpose. Choice D, 'To treat allergic reactions,' is incorrect as antiemetics are not primarily used for treating allergic reactions.

3. How should a healthcare professional manage a patient with respiratory distress?

• A. Administer bronchodilators
• B. Administer oxygen
• C. Check oxygen saturation
• D. Reposition the patient

Correct answer: B

Rationale: Administering oxygen is crucial in managing a patient with respiratory distress as it helps improve oxygenation and alleviate breathing difficulties. While administering bronchodilators may be beneficial in certain respiratory conditions like asthma or COPD, in a patient with respiratory distress, ensuring adequate oxygen supply takes precedence. Checking oxygen saturation is important, but the immediate intervention to address respiratory distress is providing supplemental oxygen. Repositioning the patient may be helpful in optimizing ventilation but is not the primary intervention in managing acute respiratory distress.

4. A nurse is caring for a client who has a chest tube. Which of the following actions should the nurse take?

• A. Clamp the chest tube for 15 minutes every 2 hours.
• B. Empty the drainage collection chamber when it is half full.
• C. Keep the drainage system below the level of the client's chest.
• D. Strip the chest tube every 2 hours to maintain patency.

Correct answer: C

Rationale: The correct action the nurse should take when caring for a client with a chest tube is to keep the drainage system below the level of the client's chest. This positioning helps prevent fluid from flowing back into the pleural space, ensuring proper drainage and effective functioning of the chest tube. Clamping the chest tube intermittently or stripping it frequently can lead to complications and should be avoided. Emptying the drainage collection chamber at specific intervals may vary based on institutional protocols, but it should be done when it is no more than two-thirds full to prevent backflow and maintain accurate monitoring of drainage output.

5. A nurse is preparing to administer an IV medication to a client who has an allergy to latex. Which of the following actions should the nurse take?

• A. Use latex gloves when administering the medication.
• B. Use latex-free syringes when administering the medication.
• C. Administer the medication through a latex-free IV port.
• D. Administer the medication with a latex-free syringe.

Correct answer: C

Rationale: The correct action for the nurse to take when preparing to administer IV medication to a client with a latex allergy is to administer the medication through a latex-free IV port. This is crucial as it prevents direct contact of the medication with latex, reducing the risk of an allergic reaction. Choice A is incorrect as using latex gloves can still expose the client to latex. Choice B is not the best option since the administration route is not specified, and using a latex-free syringe alone may not be sufficient to prevent exposure. Choice D is not the most appropriate because the IV tubing and ports should also be latex-free to ensure complete avoidance of latex contact.

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