Nursing Elites

1. A healthcare professional is preparing to administer enoxaparin subcutaneously to a client. Which of the following actions should the healthcare professional take?

• A. Administer the medication with the needle at a 45-degree angle.
• B. Administer the medication with the needle at a 90-degree angle.
• C. Inject the medication into the muscle.
• D. Pinch the skin before injecting.

Correct answer: B

Rationale: Enoxaparin is a medication that is administered subcutaneously, which means it should be injected into the fatty tissue layer beneath the skin. Administering enoxaparin at a 90-degree angle ensures proper absorption and reduces the risk of injecting the medication into muscle tissue, which could affect its effectiveness. Injecting the medication at a 45-degree angle may lead to improper absorption as it may not reach the subcutaneous tissue adequately. Injecting the medication into the muscle instead of subcutaneously can alter the absorption rate and therapeutic effects. Pinching the skin before injecting is not necessary for administering enoxaparin subcutaneously and may cause unnecessary discomfort to the client.

2. During a skin assessment, a client expresses concern about skin cancer due to a lesion on the anterior thigh. Which of the following findings should the nurse report to the provider as a possible indication of a skin malignancy?

• A. An uneven shape
• B. A uniformly colored lesion
• C. A lesion that is small and flat
• D. A lesion that is less than 1 cm in diameter

Correct answer: A

Rationale: An uneven shape of a lesion is a common characteristic of malignant skin lesions. Asymmetric or irregularly shaped lesions are concerning for skin cancer and should be reported promptly for further evaluation and management. Choice B, a uniformly colored lesion, is more indicative of a benign lesion as malignant lesions often exhibit variations in color. Choice C, a lesion that is small and flat, does not necessarily indicate malignancy by itself. Choice D, a lesion that is less than 1 cm in diameter, is more suggestive of a benign lesion, as malignant lesions are typically larger in size.

3. A nurse in a health clinic is caring for a 20-year-old client who tells the nurse that their last physical exam was in high school. Which of the following health screenings should the nurse expect the provider to perform for this client?

• A. Testicular examination
• B. Blood glucose
• C. Fecal occult blood
• D. Prostate-specific antigen

Correct answer: A

Rationale: A testicular examination is appropriate for a 20-year-old male to screen for testicular cancer, which is more common in younger age groups. Testicular cancer is most frequently diagnosed in individuals between the ages of 15 and 40. Blood glucose screening is typically recommended for older individuals or those at risk for diabetes. Fecal occult blood testing is used for colorectal cancer screening, usually starting at age 50. Prostate-specific antigen testing is commonly considered for prostate cancer screening in older males, typically around age 50. Therefore, the most appropriate screening for the 20-year-old client is the testicular examination.

4. A nurse is preparing to administer an injection of an opioid medication to a client. The nurse draws out 1 mL of the medication from a 2 mL vial. Which of the following actions should the nurse take?

• A. Ask another nurse to observe the medication wastage
• B. Notify the pharmacy when wasting the medication
• C. Lock the remaining medication in the controlled substance cabinet
• D. Dispose of the vial with the remaining medication in a sharps container

Correct answer: A

Rationale: In medication wastage situations involving controlled substances, it is crucial to have a second nurse observe and verify the disposal process. This practice ensures accountability and prevents any mishandling or diversion of the medication. Choice B is incorrect because notifying the pharmacy is not the immediate action required in this scenario. Choice C is incorrect as locking the remaining medication in the controlled substance cabinet without proper witnessing does not ensure accountability. Choice D is incorrect as disposing of the vial with the remaining medication in a sharps container does not address the need for a witness to verify the wastage of the controlled substance.

5. A healthcare professional is measuring vital signs for a client and notices an irregularity in the pulse. Which of the following actions should the healthcare professional take?

• A. Count the apical pulse rate for 1 full minute, and describe the rhythm in the chart.
• B. Recheck the pulse at the same site after 5 minutes.
• C. Measure the client’s blood pressure.
• D. Record the irregularity and continue with other vital signs.

Correct answer: A

Rationale: When an irregular pulse is detected, it is essential to count the apical pulse rate for a full minute to accurately determine the rhythm. This ensures a comprehensive assessment and helps in identifying any potential issues or abnormalities. Rechecking the pulse at the same site after 5 minutes (Choice B) may not provide an immediate understanding of the irregularity. Measuring the client's blood pressure (Choice C) is important but not directly related to addressing the irregular pulse. Recording the irregularity and continuing with other vital signs (Choice D) may overlook a potentially serious cardiac issue that requires immediate attention.

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