Nursing Elites

1. A healthcare provider is planning care for a client who is receiving total parenteral nutrition (TPN). Which of the following actions should the healthcare provider include?

• A. Administer 0.9% sodium chloride with the TPN.
• B. Change the TPN tubing every 24 hours.
• C. Weigh the client every 72 hours.
• D. Flush the TPN line with heparin.

Correct answer: B

Rationale: The correct action the healthcare provider should include is changing the TPN tubing every 24 hours to decrease the risk of infection. Administering 0.9% sodium chloride with TPN is not typically recommended as it can cause chemical instability. Weighing the client every 72 hours is important but not directly related to TPN administration. Flushing the TPN line with heparin is not a standard practice and not recommended as it can increase the risk of complications.

2. A nurse is preparing to administer vancomycin IV to a client. Which of the following actions should the nurse take?

• A. Administer the medication over 30 minutes.
• B. Monitor the client for a decrease in blood pressure during administration.
• C. Assess the IV site for infiltration during administration.
• D. Premedicate the client with an antiemetic prior to administration.

Correct answer: C

Rationale: The correct action the nurse should take when administering vancomycin IV is to assess the IV site for infiltration during administration. Vancomycin is known to cause tissue damage if it infiltrates, making close monitoring crucial. Administering the medication over 30 minutes (Choice A) is a common practice but not the priority in preventing infiltration. Monitoring for a decrease in blood pressure (Choice B) is not directly related to vancomycin administration. Premedicating with an antiemetic (Choice D) is not typically required for vancomycin administration.

3. A nurse is providing discharge teaching to a client with type 2 diabetes mellitus. Which of the following resources should the nurse provide?

• A. Personal blogs about managing diabetes medications.
• B. Food label recommendations from the Institute of Medicine.
• C. Diabetes medication information from the Physicians' Desk Reference.
• D. Food exchange lists for meal planning from the American Diabetes Association.

Correct answer: D

Rationale: The correct answer is D. Food exchange lists are valuable resources for individuals with diabetes as they provide structured meal planning guidance. This helps individuals manage their diabetes effectively by controlling their carbohydrate intake. Choices A, B, and C are incorrect because personal blogs may not provide reliable and evidence-based information, food label recommendations from the Institute of Medicine may not be specific for diabetes meal planning, and diabetes medication information from the Physicians' Desk Reference is not directly related to meal planning for diabetes management.

4. When documenting an incorrect dose of medication administered, which fact related to the incident report should the nurse document in the client's medical record?

• A. Time the medication was given
• B. The client's response to the medication
• C. The dose that was administered
• D. Reason for the error

Correct answer: A

Rationale: The nurse should document the time the medication was given in the client's medical record when an incorrect dose is administered. Recording the time is crucial for establishing the sequence of events accurately. Choices B, C, and D, though important, are not directly relevant to documenting the incident of administering an incorrect dose of medication. The client's response to the medication, the actual dose administered, and the reason for the error may be documented for overall patient care but are not specifically required in the incident report for an incorrect dose.

5. A client at 32 weeks of gestation with preeclampsia is receiving teaching from a nurse. Which statement by the client indicates an understanding of the teaching?

• A. I will take a daily aspirin to prevent blood clots.
• B. I will call my provider if I experience swelling in my hands.
• C. I should increase my calcium intake to prevent seizures.
• D. I will restrict my protein intake to prevent further kidney damage.

Correct answer: B

Rationale: The correct answer is B because swelling in the hands is a potential sign of worsening preeclampsia, and the client should report this to their provider. Choice A is incorrect since aspirin is not recommended in preeclampsia. Choice C is incorrect as calcium intake is not directly related to preventing seizures in preeclampsia. Choice D is incorrect because protein restriction is not the standard management for preventing further kidney damage in preeclampsia.

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