Nursing Elites

1. A nurse is preparing to administer medications to a client who is NPO and is receiving enteral feedings through an NG tube. Which of the following prescriptions should the nurse clarify with the provider?

• A. Metoprolol ER 50 mg via NG tube BID
• B. Acetaminophen 650 mg PO BID
• C. Lisinopril 10 mg PO daily
• D. Ondansetron 4 mg IV push PRN

Correct answer: B

Rationale: The nurse should clarify prescription B, Acetaminophen 650 mg PO BID, with the provider. When a patient is NPO and receiving enteral feedings through an NG tube, medications administered orally may be contraindicated due to the risk of aspiration. Therefore, Acetaminophen should be confirmed for safety in this situation. The other options (Metoprolol ER 50 mg via NG tube BID, Lisinopril 10 mg PO daily, Ondansetron 4 mg IV push PRN) are appropriate and do not need clarification in this scenario.

2. What are the key considerations for managing a patient with COPD?

• A. Bronchodilators
• B. Smoking cessation
• C. Pulmonary rehabilitation
• D. Oxygen therapy

Correct answer: D

Rationale: The key considerations for managing a patient with COPD include oxygen therapy, which is essential to maintain adequate oxygen saturation levels. While bronchodilators are commonly used to manage COPD symptoms, they are not the primary consideration. Smoking cessation is crucial in preventing further damage but is not a direct management consideration. Pulmonary rehabilitation is beneficial for improving exercise capacity and quality of life but is not as crucial as ensuring adequate oxygen therapy.

3. How should a healthcare professional manage a patient with diarrhea?

• A. Provide oral fluids and monitor stool consistency
• B. Administer antidiarrheal medications and monitor hydration
• C. Monitor for electrolyte imbalances and provide antibiotics
• D. Provide a low-fiber diet and monitor weight

Correct answer: A

Rationale: For a patient with diarrhea, the priority is to manage dehydration by providing oral fluids and monitoring stool consistency. Option B suggesting administering antidiarrheal medications is not recommended as it may prolong the infection by preventing the body from expelling the infectious agent. Option C is incorrect because antibiotics are not routinely indicated for diarrhea unless there is a specific bacterial infection. Option D is not the most appropriate initial intervention for managing diarrhea since a low-fiber diet may not provide adequate nutrition for the patient or help resolve the underlying cause of diarrhea.

4. A nurse is collecting data from a client who has multiple fractures following a motor-vehicle crash. For which of the following client statements should the nurse recommend a referral to an occupational therapist?

• A. I am frustrated that I cannot lift my arm to comb my hair.
• B. I am upset that I can't hold a pencil anymore.
• C. I am embarrassed that I cannot open my milk carton.
• D. I am so frustrated that I cannot even open my milk carton for breakfast.

Correct answer: D

Rationale: The correct answer is D because the inability to perform activities of daily living, such as opening a milk carton, suggests difficulties with fine motor skills. Occupational therapists specialize in helping individuals regain independence in such tasks. Choices A, B, and C do not specifically address fine motor skills related to activities of daily living, therefore not warranting an occupational therapy referral. Choice A mentions lifting the arm, which involves gross motor skills rather than fine motor skills. Choice B involves holding a pencil, which is more related to hand dexterity and strength rather than fine motor skills. Choice C, opening a milk carton, could be related to fine motor skills but is not as clear-cut as the inability described in Choice D, where the frustration is explicitly about the inability to perform a daily living task.

5. A nurse is contributing to the plan of care for a client who has a chest tube connected to a closed drainage system. Which of the following interventions should the nurse include?

• A. Clamp the chest tube
• B. Maintain the drainage below the level of the chest
• C. Elevate the chest tube above chest level
• D. Avoid frequent dressing changes

Correct answer: B

Rationale: The correct intervention for a client with a chest tube connected to a closed drainage system is to maintain the drainage below the level of the chest. This position allows proper drainage of fluids and helps prevent complications such as backflow of blood or fluids into the chest cavity. Clamping the chest tube (Choice A) is incorrect as it can lead to a tension pneumothorax. Elevating the chest tube above chest level (Choice C) is also incorrect because it can impede proper drainage. Avoiding frequent dressing changes (Choice D) is important to prevent introducing infection, but it is not directly related to the position of the drainage system.

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