Nursing Elites

1. A nurse is preparing medications for a client via nasogastric tube. What should the nurse do before administering the medications?

• A. Flush the tube with water and administer all medications at once
• B. Administer medications one after the other without flushing
• C. Crush all medications and mix them together for administration
• D. Administer medications in liquid form only

Correct answer: B

Rationale: Before administering medications through a nasogastric tube, the nurse should administer them one after the other without flushing. Flushing the tube with water should be done before and after each medication to prevent any interactions and ensure each medication is delivered effectively. The correct answer is not to administer all medications at once (choice A) as this can lead to potential drug interactions. Crushing all medications and mixing them together (choice C) is incorrect as each medication should be given separately to maintain their individual efficacy. Administering medications in liquid form only (choice D) is limiting and may not be suitable for all types of medications that need to be administered.

2. A client with hyperthyroidism is prescribed propranolol. Which finding indicates that the propranolol is effective?

• A. The client reports an increase in weight
• B. The client has a decrease in blood pressure
• C. The client reports an increase in energy
• D. The client's respiratory rate has increased

Correct answer: B

Rationale: The correct answer is B because a decrease in blood pressure is an expected outcome when propranolol, a beta-blocker, is effectively managing hyperthyroidism. Propranolol helps control symptoms such as tachycardia and hypertension associated with hyperthyroidism. Choices A, C, and D are incorrect because weight gain, increased energy, and an increased respiratory rate are not direct indicators of propranolol's effectiveness in treating hyperthyroidism.

3. Which of the following clients requiring crutches should a nurse teach about how to use a three-point gait?

• A. A client who has a right femur fracture with no weight-bearing on the affected leg
• B. A client who has bilateral leg braces due to paralysis of the lower extremities
• C. A client who has bilateral knee replacements with partial weight-bearing on both legs
• D. A client who is able to bear full weight on both lower extremities

Correct answer: A

Rationale: A three-point gait is recommended for clients who are non-weight bearing on one leg. In this case, a client with a right femur fracture requiring no weight-bearing on the affected leg would benefit from learning how to use a three-point gait. Choices B, C, and D are incorrect because they involve clients who have varying degrees of weight-bearing ability on both legs, which would not require the use of a three-point gait.

4. Which intervention is most effective for managing a patient with constipation?

• A. Increase the patient's fluid intake.
• B. Administer a stool softener as prescribed.
• C. Provide the patient with a high-fiber diet.
• D. Teach the patient to perform Valsalva maneuvers.

Correct answer: B

Rationale: The most effective intervention for managing constipation in a patient is to administer a stool softener as prescribed. Stool softeners help relieve constipation by making the stool easier to pass, especially in postoperative patients. Increasing fluid intake can be beneficial but may not address the underlying cause of constipation. While a high-fiber diet is important for bowel health, it may not provide immediate relief for constipation. Teaching a patient to perform Valsalva maneuvers is not recommended for managing constipation as it can lead to adverse effects like increasing intra-abdominal pressure.

5. A nurse manager of a rural clinic is orienting a new employee. Which of the following information should the nurse include as a characteristic of rural health?

• A. Lower rates of maternal morbidity
• B. Reduced incidence of death from motor-vehicle crashes
• C. Increased rates of chronic illness
• D. More frequent dental preventative care visits

Correct answer: C

Rationale: The correct answer is C: 'Increased rates of chronic illness.' Rural areas often face challenges such as limited access to healthcare services, healthcare provider shortages, socioeconomic factors, and lifestyle choices that contribute to higher rates of chronic illnesses. Maternal morbidity rates are typically higher in rural areas due to limited access to obstetric care. While rural areas may have fewer motor-vehicle crashes compared to urban areas, the severity of crashes is usually higher due to factors like longer emergency response times. Dental care access can also be limited in rural areas, leading to less frequent preventative care visits.

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