Nursing Elites

1. A nurse is preparing to administer a dose of vancomycin IV to a client who has a methicillin-resistant Staphylococcus aureus (MRSA) infection. Which of the following actions should the nurse take?

• A. Administer the medication over 15 minutes.
• B. Monitor the client's urine output every 8 hours.
• C. Check the client's creatinine level before administering the medication.
• D. Assess the client for a history of allergies to antibiotics.

Correct answer: C

Rationale: The correct action for the nurse to take is to check the client's creatinine level before administering vancomycin. Vancomycin is known to be nephrotoxic, so assessing the client's renal function before administering the medication is crucial to prevent further kidney damage. Administering the medication over 15 minutes (Choice A) is not the priority in this scenario as renal function assessment takes precedence. Monitoring urine output (Choice B) is important for assessing renal function but checking creatinine level directly provides more accurate information. Assessing for allergies to antibiotics (Choice D) is also important but not as essential as checking the creatinine level due to the nephrotoxic nature of vancomycin.

2. How should a healthcare provider care for a patient who is refusing medication?

• A. Assess the reasons for refusal
• B. Explore alternative treatment options
• C. Document the refusal
• D. Discontinue the medication

Correct answer: A

Rationale: When a patient refuses medication, it is essential for the healthcare provider to assess the reasons for refusal. This allows the provider to understand the patient's concerns, provide education or clarification if needed, and work collaboratively with the patient to find a solution. Exploring alternative treatment options may be necessary after understanding the reasons behind the refusal. Documenting the refusal is important for legal and continuity of care purposes, but it is not the initial action to take. Discontinuing the medication without understanding the patient's reasons for refusal can lead to potential harm and is not a recommended approach.

3. A client is experiencing mild anxiety. Which of the following findings should the nurse expect?

• A. Feelings of dread
• B. Heightened perceptual field
• C. Rapid speech
• D. Purposeless activity

Correct answer: B

Rationale: In clients experiencing mild anxiety, a heightened perceptual field is a common finding. This means that the individual may be more alert and observant of their surroundings, sometimes to the point of being hyper-aware. Choices A, C, and D are less likely to be associated with mild anxiety. Feelings of dread (Choice A) are more commonly seen in moderate to severe anxiety. Rapid speech (Choice C) may be observed in some cases of anxiety, but it is not a specific hallmark of mild anxiety. Purposeless activity (Choice D) is more indicative of severe anxiety or other mental health conditions.

4. A nurse is preparing to teach a client about the use of a peak flow meter. Which of the following instructions should the nurse include?

• A. Place the mouthpiece in your mouth and blow out as quickly as you can.
• B. Exhale slowly into the mouthpiece over 5 seconds.
• C. Take a slow deep breath before blowing into the mouthpiece.
• D. Blow into the mouthpiece at a steady rate for 3 seconds.

Correct answer: A

Rationale: The correct instruction for using a peak flow meter is to place the mouthpiece in your mouth and blow out as quickly as you can. This action helps measure the peak expiratory flow of the client. Choice B is incorrect because exhaling slowly does not provide an accurate peak flow reading. Choice C is incorrect as taking a slow deep breath before blowing interferes with obtaining an accurate measurement. Choice D is incorrect as blowing at a steady rate for 3 seconds may not reflect the peak expiratory flow accurately.

5. A nurse is caring for a client who is newly diagnosed with pancreatic cancer and has questions about the disease. To research, the nurse should identify which of the following electronic databases has the most comprehensive collection of nursing articles?

• A. MEDLINE
• B. CINAHL
• C. ProQuest
• D. Health Source

Correct answer: B

Rationale: The correct answer is B, CINAHL. CINAHL is specifically dedicated to nursing and allied health literature, making it the most appropriate database for nursing articles and research. It provides a comprehensive collection of nursing-related articles, journals, and research studies, which are essential for evidence-based practice. MEDLINE, on the other hand, is a valuable resource for medical literature but is not as nursing-focused as CINAHL. ProQuest and Health Source cover a wider range of subjects beyond nursing, so they are not as comprehensive when it comes to nursing-specific articles and research. Therefore, for the nurse looking to access a database with a vast collection of nursing articles, CINAHL is the most suitable option.

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