Nursing Elites

1. A nurse is caring for a client with pneumonia who has a new prescription for antibiotics. Which of the following actions should the nurse take first?

• A. Administer the antibiotic immediately
• B. Obtain a sputum culture
• C. Notify the provider of the prescription
• D. Check the client's allergy history

Correct answer: B

Rationale: The correct first action for the nurse to take when caring for a client with pneumonia who has a new prescription for antibiotics is to obtain a sputum culture. This is important to identify the specific bacteria causing the pneumonia before administering antibiotics. Administering the antibiotic immediately (Choice A) may not be appropriate without knowing the specific pathogen. Notifying the provider of the prescription (Choice C) is important but not the first action to be taken. Checking the client's allergy history (Choice D) is relevant but not the priority in this situation.

2. An occupational health nurse in a factory is planning interventions to reduce environmental stressors for employees. Which of the following interventions should the nurse use to affect physical agents in the environment?

• A. Teach workers to choose personal strategies to cope with work stress
• B. Limit the amount of time workers spend in temperatures over 43.3°C (110°F)
• C. Provide ear plugs for use at workstations throughout the factory
• D. Obtain dosimeters for employees to wear when using new machinery that emits radiation

Correct answer: B

Rationale: Limiting exposure to extreme temperatures is important to protect workers from heat-related illnesses.

3. A healthcare professional is reviewing the medical records of a client who has a pressure ulcer. Which of the following findings should the professional expect?

• A. Albumin level of 3
• B. Hemoglobin of 12
• C. Normal skin moisture
• D. No signs of infection

Correct answer: A

Rationale: The correct answer is A: Albumin level of 3. A low albumin level indicates poor nutrition, which can contribute to the development of pressure ulcers. Choice B, Hemoglobin of 12, is within the normal range and is not directly associated with pressure ulcers. Choice C, Normal skin moisture, does not provide specific information related to pressure ulcers. Choice D, No signs of infection, while important, is not a direct finding associated with pressure ulcers.

4. What is the priority when assessing a patient for possible deep vein thrombosis (DVT)?

• A. Dorsiflex the foot and check for pain.
• B. Measure the calf circumference of both legs.
• C. Check the skin for signs of redness.
• D. Perform a Doppler ultrasound scan.

Correct answer: B

Rationale: The correct answer is to measure the calf circumference of both legs when assessing a patient for possible DVT. An increase in calf circumference in one leg can indicate the presence of a DVT. Option A is incorrect because dorsiflexing the foot and checking for pain are not primary assessments for DVT. Option C is incorrect as redness of the skin may not always be present in cases of DVT. Option D is incorrect as performing a Doppler ultrasound scan is usually done after clinical assessment and to confirm the diagnosis, not as the initial priority assessment.

5. Which of the following is a critical nursing action when managing a patient with a chest tube?

• A. Keep the chest tube clamped at all times.
• B. Ensure the chest tube is connected to a closed drainage system.
• C. Empty the chest tube drainage system every 2 hours.
• D. Disconnect the chest tube when the patient is ambulating.

Correct answer: B

Rationale: The correct answer is B: "Ensure the chest tube is connected to a closed drainage system." This is a critical nursing action when managing a patient with a chest tube because it is essential for proper drainage and to prevent complications such as air leaks or infections. Option A is incorrect because keeping the chest tube clamped at all times would prevent proper drainage and could lead to complications. Option C is incorrect as emptying the chest tube drainage system should be done based on assessment findings rather than a fixed time interval. Option D is incorrect because disconnecting the chest tube when the patient is ambulating can lead to complications like a pneumothorax.

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