Nursing Elites

1. A nurse is planning to administer an injection of morphine to a client. Which of the following actions should the nurse take to ensure client safety?

• A. Instruct the client to take a deep breath during administration.
• B. Administer the medication over 30 seconds.
• C. Verify the client’s pain level.
• D. Have naloxone available in case of respiratory depression.

Correct answer: D

Rationale: The correct answer is to have naloxone available in case of respiratory depression. Morphine is an opioid that can lead to respiratory depression, especially in higher doses. Naloxone is the antidote for opioid overdose and should be readily accessible when administering morphine to reverse respiratory depression if it occurs. Instructing the client to take a deep breath during administration (choice A) is not directly related to ensuring safety in this scenario. Administering the medication over 30 seconds (choice B) may help with the comfort of the client but does not address the potential risk of respiratory depression. Verifying the client's pain level (choice C) is important but not the primary action to ensure safety when administering morphine.

2. A school nurse is developing a teaching plan about testicular cancer for a group of adolescents. What information should the nurse include in the teaching?

• A. Expect pain in the testicles during self-examination.
• B. The testicles should be uniform in size and shape when examined.
• C. Expect testicles to be uniform in consistency when performing a testicular self-examination.
• D. The testicles will shrink if cancer is present.

Correct answer: C

Rationale: The correct answer is C because during a testicular self-examination, it is crucial to note a uniform consistency of the testicles. Any lumps, changes in size, or inconsistencies should be reported to a healthcare provider promptly. Choice A is incorrect because pain is not typically expected during a testicular self-examination. Choice B is incorrect as uniform size and shape are not as relevant as uniform consistency. Choice D is incorrect; testicular cancer usually causes enlargement rather than shrinking of the testicles.

3. A nurse is assessing a 1-hour postpartum client and notes a boggy uterus located 2 cm above the umbilicus. Which of the following actions should the nurse take first?

• A. Take vital signs
• B. Assess lochia
• C. Massage the fundus
• D. Give oxytocin IV bolus

Correct answer: C

Rationale: When a nurse assesses a 1-hour postpartum client with a boggy uterus located 2 cm above the umbilicus, it indicates uterine atony. The first action the nurse should take is to massage the fundus. Fundal massage helps stimulate uterine contractions, which will reduce bleeding and prevent postpartum hemorrhage. Taking vital signs, assessing lochia, or administering an oxytocin IV bolus are important interventions but should come after addressing uterine atony through fundal massage.

4. A client with a history of asthma is being cared for by a nurse. Which of the following should the nurse monitor?

• A. Heart rate
• B. Respiratory status
• C. Blood glucose levels
• D. Liver function

Correct answer: B

Rationale: The correct answer is B: Respiratory status. When caring for a client with asthma, it is essential to monitor their respiratory status to detect any changes in breathing or signs of airway obstruction. Monitoring heart rate (choice A) may be important in some situations but is not the priority when managing asthma. Blood glucose levels (choice C) and liver function (choice D) are not directly related to asthma and would not be the primary focus of monitoring for a client with this condition.

5. A healthcare professional is assessing a client for signs of hypoglycemia. Which of the following findings should the healthcare professional look for?

• A. Increased thirst
• B. Fatigue
• C. Weight gain
• D. Elevated blood pressure

Correct answer: B

Rationale: The correct answer is B: Fatigue. Fatigue, along with symptoms like shakiness and irritability, are common signs of hypoglycemia. Increased thirst (Choice A) is more indicative of hyperglycemia. Weight gain (Choice C) is not typically associated with hypoglycemia. Elevated blood pressure (Choice D) is not a common sign of hypoglycemia.

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