Nursing Elites

1. A nurse is providing discharge teaching to a client who has a new prescription for warfarin. Which of the following statements indicates an understanding of the teaching?

• A. I should avoid taking acetaminophen while taking this medication
• B. I will take this medication at the same time each day
• C. I will need to get my blood tested regularly while taking this medication
• D. I should increase my intake of leafy green vegetables

Correct answer: C

Rationale: The correct answer is C. Warfarin therapy requires regular blood testing to monitor INR levels and ensure therapeutic dosing. Option A is incorrect because acetaminophen can be taken with warfarin. Option B is not specific to warfarin administration. Option D is incorrect as it does not address the key monitoring requirement of blood testing while on warfarin.

2. A client with a urinary tract infection is prescribed ciprofloxacin. Which instruction should the nurse provide?

• A. Continue taking this medication until you feel better
• B. Take this medication with milk or food
• C. Take the medication with an antacid
• D. Avoid caffeine while taking this medication

Correct answer: D

Rationale: The correct instruction for the nurse to provide to a client taking ciprofloxacin for a urinary tract infection is to avoid caffeine. Ciprofloxacin can interact with caffeine, potentially leading to increased side effects or reduced effectiveness. Choice A is incorrect because antibiotics should be taken for the full prescribed course, even if the client starts feeling better. Choice B is incorrect as ciprofloxacin should not be taken with dairy products or antacids as they can interfere with the absorption of the medication.

3. What are the clinical signs of hyperglycemia in a patient with diabetes mellitus, and how should a nurse respond?

• A. Monitoring blood glucose levels and administering insulin
• B. Polyuria, polydipsia, and polyphagia
• C. Fatigue, blurred vision, and fruity breath
• D. Educating the patient on blood glucose monitoring

Correct answer: B

Rationale: The correct signs of hyperglycemia in a patient with diabetes mellitus are polyuria (excessive urination), polydipsia (excessive thirst), and polyphagia (excessive hunger). These symptoms indicate high blood sugar levels. Therefore, the correct response for a nurse would be to recognize these signs, monitor blood glucose levels, and administer insulin to manage the hyperglycemia. Choice A is incorrect because it only addresses the response aspect without mentioning the signs. Choices C and D are incorrect as they do not reflect the classic clinical signs of hyperglycemia in diabetes mellitus.

4. A nurse is preparing to discontinue a client's indwelling urinary catheter. Which of the following actions should the nurse take first?

• A. Measure and document the urine in the drainage bag
• B. Remove the tape or device securing the catheter to the client's thigh
• C. Position the client supine
• D. Deflate the catheter balloon using a sterile syringe

Correct answer: A

Rationale: The correct first action the nurse should take when discontinuing a client's indwelling urinary catheter is to measure and document the urine in the drainage bag. This step is essential to assess the client's urinary output and bladder function before removing the catheter. Removing the tape securing the catheter (Choice B) or positioning the client supine (Choice C) should come after measuring and documenting the urine output. Deflating the catheter balloon (Choice D) is the last step in the process of removing the catheter.

5. What are the clinical manifestations of hypovolemic shock, and how should a nurse respond?

• A. Hypertension, bradycardia, and oliguria
• B. Bradycardia, hypertension, and peripheral edema
• C. Tachypnea, cool skin, and confusion
• D. Tachycardia, hypotension, and decreased urine output

Correct answer: D

Rationale: The correct answer is D: Tachycardia, hypotension, and decreased urine output are classic clinical manifestations of hypovolemic shock. In hypovolemic shock, the body tries to compensate for low blood volume by increasing the heart rate (tachycardia) to maintain cardiac output, leading to hypotension and decreased urine output. Prompt fluid replacement is necessary to restore intravascular volume. Choices A, B, and C are incorrect because they do not represent the typical manifestations of hypovolemic shock.

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