Nursing Elites

1. A healthcare professional is preparing to administer an intramuscular injection to a client. Which of the following actions should the healthcare professional take?

• A. Use a 1-inch needle.
• B. Stretch the skin at the injection site.
• C. Insert the needle at a 90-degree angle.
• D. Aspirate for blood return before injecting.

Correct answer: D

Rationale: Aspirating for blood return before injecting is a crucial step in administering intramuscular injections. This action ensures that the needle is not in a blood vessel, reducing the risk of injecting medication into a blood vessel, which can lead to potential complications. Choices A, B, and C are incorrect. Using a longer 1-inch needle is often necessary for intramuscular injections to reach the muscle tissue properly. Stretching the skin is not recommended as it can cause unnecessary pain and tissue damage. Inserting the needle at a 90-degree angle is the preferred method for intramuscular injections to ensure proper medication delivery.

2. Which of the following statements indicates the client understands the colostomy care instructions?

• A. I will change the colostomy bag once a week.
• B. I will avoid eating high-fiber foods.
• C. I will clean around the stoma with mild soap and water.
• D. I will apply lotion to the skin around the stoma.

Correct answer: C

Rationale: The correct answer is C. Cleaning around the stoma with mild soap and water is crucial for colostomy care as it helps prevent infection and skin irritation. Changing the colostomy bag frequency, dietary modifications, or applying lotion are not primary aspects of stoma care. Proper cleaning around the stoma helps maintain hygiene and prevents complications, making it a key component of caring for a colostomy.

3. What action should a healthcare provider take for a client with a new colostomy?

• A. Empty the colostomy bag when it is half full.
• B. Place aspirin in the colostomy bag to decrease odor.
• C. Use sterile technique when caring for the stoma.
• D. Change the pouch every 8 hours.

Correct answer: A

Rationale: Emptying the colostomy bag when it is half full is crucial to prevent leakage and detachment from the skin. This practice helps to maintain the integrity of the colostomy system, reducing the risk of skin irritation and odor. It is essential for client comfort and overall stoma care.

4. A nurse is providing discharge teaching to a client who has a prescription for digoxin. Which of the following instructions should the nurse include?

• A. Take your pulse before taking the medication.
• B. Take the medication with an antacid.
• C. Double the dose if you miss one.
• D. Take the medication with a high-fiber meal.

Correct answer: A

Rationale: The correct answer is A: 'Take your pulse before taking the medication.' When administering digoxin, it is crucial to monitor the pulse rate because digoxin can cause bradycardia (slow heart rate). Checking the pulse helps in assessing the heart rate before taking the medication, as bradycardia is a common side effect of digoxin. Choice B is incorrect because digoxin should not be taken with antacids, as they can reduce its absorption. Choice C is incorrect; the dose should never be doubled if a dose is missed. Choice D is incorrect because taking digoxin with a high-fiber meal can also affect its absorption. Therefore, the essential instruction for the client is to monitor the pulse before taking digoxin.

5. A healthcare professional is providing discharge teaching to a client who has a new prescription for warfarin. Which of the following instructions should the healthcare professional include?

• A. Avoid drinking grapefruit juice.
• B. Take aspirin for pain relief.
• C. Consume a consistent amount of green leafy vegetables.
• D. Use an electric razor when shaving.

Correct answer: C

Rationale: Consuming a consistent amount of green leafy vegetables is important for clients taking warfarin as these foods contain vitamin K, which can affect the medication's effectiveness. Maintaining a consistent intake helps stabilize the International Normalized Ratio (INR) levels, which is crucial for monitoring the blood's ability to clot properly while on warfarin therapy. Choices A, B, and D are incorrect. Avoiding grapefruit juice is generally recommended with certain medications due to its interaction with liver enzymes, which is not directly related to warfarin. Taking aspirin along with warfarin can increase the risk of bleeding. Using an electric razor when shaving is a safety precaution for those at risk of bleeding, but it is not directly related to the medication warfarin.

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