Nursing Elites

1. A client has a new prescription for nitroglycerin sublingual tablets. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Place the tablet under your tongue and let it dissolve completely.
• C. Swallow the tablet whole with a glass of water.
• D. Chew the tablet for faster relief.

Correct answer: B

Rationale: The correct instruction for a client prescribed nitroglycerin sublingual tablets is to place the tablet under the tongue and let it dissolve completely. This route of administration allows for rapid absorption of the medication through the oral mucosa, providing quick relief for angina symptoms. Option A, taking the medication with food, is incorrect as nitroglycerin should be taken sublingually, not with food. Option C, swallowing the tablet whole with water, is incorrect as sublingual tablets should not be swallowed whole. Option D, chewing the tablet for faster relief, is also incorrect as chewing the tablet can lead to rapid absorption and potential adverse effects rather than a controlled release for angina relief.

2. A healthcare professional is explaining the use of written consent forms to a newly-licensed healthcare professional. The healthcare professional should ensure that a written consent form has been signed by which of the following clients?

• A. A client who has a prescription for a transfusion of packed red blood cells.
• B. A client who is scheduled for a routine physical examination.
• C. A client who is undergoing a minor surgical procedure without anesthesia.
• D. A client who has been prescribed a new medication.

Correct answer: A

Rationale: Correct! Written consent is required for procedures that carry significant risks, such as blood transfusions, to ensure the client’s informed consent and understanding of the procedure. In this case, a transfusion of packed red blood cells is an invasive procedure that carries risks, making it essential to have the client's written consent. Choices B, C, and D do not typically require written consent as routine physical examinations, minor surgical procedures without anesthesia, and new medication prescriptions do not carry the same level of risk and complexity as a blood transfusion.

3. The nurse is caring for a client with a tracheostomy who is unable to clear secretions by coughing. What is the most appropriate action for the nurse to take?

• A. Encourage the client to take deep breaths.
• B. Provide humidified oxygen via tracheostomy collar.
• C. Suction the tracheostomy tube as needed.
• D. Change the tracheostomy dressing daily.

Correct answer: C

Rationale: Suctioning the tracheostomy tube as needed is the most appropriate action in this scenario. When a client with a tracheostomy is unable to clear secretions by coughing, suctioning helps remove the excess secretions from the airway, ensuring proper breathing. Encouraging deep breaths (Choice A) may not effectively address the immediate need to clear secretions. Providing humidified oxygen (Choice B) can help with oxygenation but does not directly address the issue of clearing secretions. Changing the tracheostomy dressing daily (Choice D) is important for maintaining cleanliness but is not the priority when the client is unable to clear secretions.

4. A client needs to maintain a positive nitrogen balance for wound healing. Which of the following food items should the nurse recommend as a good source of complete protein?

• A. Cheddar cheese
• B. White rice
• C. Apples
• D. Green beans

Correct answer: A

Rationale: Cheddar cheese is the correct answer as it is a good source of complete protein that contains all essential amino acids required for maintaining a positive nitrogen balance for wound healing. Complete proteins provide all essential amino acids needed by the body. White rice, apples, and green beans do not offer complete proteins like cheddar cheese, making them inadequate choices for this purpose.

5. The LPN/LVN observes that a male client has removed the covering from an ice pack applied to his knee. What action should the nurse take first?

• A. Observe the appearance of the skin under the ice pack.
• B. Instruct the client regarding the importance of the covering.
• C. Reapply the covering after filling it with fresh ice.
• D. Ask the client how long the ice pack was applied to the skin.

Correct answer: A

Rationale: The correct first action for the nurse to take when a client removes the covering from an ice pack is to observe the appearance of the skin under the ice pack. This assessment is crucial to check for any skin damage or adverse reactions resulting from direct contact with the ice pack. Instructing the client about the importance of the covering (Choice B) can follow the skin assessment. Reapplying the covering (Choice C) before skin assessment may potentially cause harm. Asking the client about the duration of ice application (Choice D) is not the immediate priority; ensuring skin integrity is the primary concern.

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