Nursing Elites

1. A nurse is caring for a client with a new prescription for enoxaparin to prevent DVT. Which of the following is an appropriate action by the nurse?

• A. Expel any air bubbles from the prefilled syringe
• B. Inject the medication in the lateral abdominal wall
• C. Massage the injection site to evenly distribute the medication
• D. Administer NSAIDs for injection site discomfort

Correct answer: B

Rationale: The correct answer is to inject enoxaparin in the lateral abdominal wall. This site is typically recommended for subcutaneous injections of this medication. Expelling air bubbles from prefilled syringes is not necessary and may result in medication loss. Massaging the injection site is contraindicated as it can cause bruising or hematoma formation. Administering NSAIDs for injection site discomfort is unnecessary and not a standard practice.

2. A nurse is assessing a client with osteoporosis who is experiencing severe pain. The client's respiratory rate is 14/min. Which of the following medications should the nurse administer first?

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

Correct answer: B

Rationale: The correct answer is B, Hydromorphone. Hydromorphone is an opioid analgesic commonly used to manage severe pain effectively. In this case, the client's stable respiratory rate of 14/min indicates that it is safe to administer an opioid for pain relief. Promethazine (choice A) is an antiemetic and antihistamine, not the first choice for severe pain management. Ketorolac (choice C) is a nonsteroidal anti-inflammatory drug (NSAID) that may not be potent enough for severe pain relief associated with osteoporosis. Amitriptyline (choice D) is a tricyclic antidepressant, not typically used as a first-line medication for severe pain.

3. A healthcare professional is completing a nutritional assessment on a client and measures body mass index (BMI). Which of the following readings correlates with a BMI of an overweight client?

• A. 18.5
• B. 24.9
• C. 25
• D. 32

Correct answer: C

Rationale: A BMI of 25-29.9 is considered overweight. Therefore, a BMI of 25 correlates with an overweight client. A BMI of 18.5-24.9 indicates a healthy weight. Choices A, B, and D are incorrect as they fall into the healthy weight or obese categories, not overweight.

4. A nurse is preparing to administer a dose of escitalopram. Which of the following should the nurse assess first?

• A. Mood changes
• B. Blood pressure
• C. Heart rate
• D. Liver function

Correct answer: A

Rationale: The correct answer is to assess for mood changes. When administering escitalopram, it is crucial to evaluate mood changes first because the medication may take some time to demonstrate its full effects on the patient's mood. Assessing blood pressure, heart rate, or liver function is not the priority when administering escitalopram, as these parameters are not directly impacted acutely by this medication.

5. A client with GERD is receiving discharge instructions from a nurse. Which statement by the client indicates an understanding of the teaching?

• A. “I should take my medicine with orange juice.”
• B. “Having a bedtime snack will prevent heartburn.”
• C. “I will lie down after meals.”
• D. “I will limit activities that require bending at the waist.”

Correct answer: D

Rationale: The correct answer is D. Limiting activities that require bending at the waist can help prevent episodes of reflux in clients with GERD. Choices A, B, and C are incorrect. Taking medicine with orange juice may not be appropriate as citrus juices can aggravate GERD. Having a bedtime snack can exacerbate heartburn by increasing stomach acid production, and lying down after meals can worsen symptoms of GERD by allowing stomach acid to flow back into the esophagus.

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