Nursing Elites

1. A client is being discharged with a new prescription for enoxaparin (Lovenox). Which instruction should the nurse include?

• A. Administer the injection in your thigh.
• B. Do not expel the air bubble from the syringe before injection.
• C. Massage the injection site after administration.
• D. Alternate the injection site between the arms.

Correct answer: B

Rationale: The correct instruction for a client with a prescription for enoxaparin (Lovenox) is not to expel the air bubble from the syringe before injection. This ensures the full dose is delivered without affecting the medication's efficacy. Expelling the air bubble may lead to a loss of medication, resulting in suboptimal treatment. Therefore, it is crucial for the client to follow this instruction to receive the intended therapeutic effect of enoxaparin.

2. A client is admitted with suspected meningitis. Which assessment finding requires immediate intervention?

• A. Headache.
• B. Fever.
• C. Nuchal rigidity.
• D. Seizures.

Correct answer: D

Rationale: Seizures in a client with suspected meningitis indicate increased intracranial pressure or other complications requiring immediate intervention. Seizures can lead to further neurological damage and need prompt management to prevent adverse outcomes. Therefore, addressing seizures promptly is crucial in the care of a client with suspected meningitis.

3. Following a CVA, the nurse assesses that a client has developed dysphagia, hypoactive bowel sounds, and a firm, distended abdomen. Which prescription for the client should the nurse question?

• A. Continuous tube feeding at 65 ml/hr via gastrostomy.
• B. Total parenteral nutrition to be infused at 125 ml/hour.
• C. Nasogastric tube connected to low intermittent suction.
• D. Metoclopramide (Reglan) intermittent piggyback.

Correct answer: A

Rationale: In a client with dysphagia and gastrointestinal symptoms such as hypoactive bowel sounds and a firm, distended abdomen, continuous tube feeding might exacerbate the symptoms. This can lead to complications and should be questioned by the nurse.

4. What instruction should a patient with a history of hypertension be provided when being discharged with a prescription for a thiazide diuretic?

• A. Avoid foods high in potassium.
• B. Take the medication at bedtime.
• C. Monitor weight daily.
• D. Limit fluid intake to 1 liter per day.

Correct answer: C

Rationale: The correct instruction for a patient with a history of hypertension being discharged with a prescription for a thiazide diuretic is to monitor weight daily. This is important because thiazide diuretics can cause fluid imbalances, and monitoring weight daily can help detect significant changes early. Choice A, avoiding foods high in potassium, is not directly related to thiazide diuretics. Choice B, taking the medication at bedtime, may vary depending on the specific medication but is not a universal instruction. Choice D, limiting fluid intake to 1 liter per day, is not appropriate as adequate hydration is important to prevent complications like hypokalemia.

5. What is the primary action of digoxin when prescribed to a patient with heart failure?

• A. Increase heart rate
• B. Decrease cardiac output
• C. Strengthen cardiac contractions
• D. Lower blood pressure

Correct answer: C

Rationale: Digoxin, when prescribed to a patient with heart failure, primarily acts by strengthening cardiac contractions. This leads to an improvement in cardiac output, making it an essential medication in managing heart failure. By enhancing the force of contractions, digoxin helps the heart pump more effectively and efficiently, leading to better circulation and symptom control in patients with compromised cardiac function.

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