Nursing Elites

1. A nurse is providing teaching to a client who has a new prescription for nitroglycerin transdermal patches. Which of the following instructions should the nurse include?

• A. Apply the patch to your upper arm.
• B. You should remove the patch before showering.
• C. Rotate the patch site each time you apply it.
• D. Apply the patch to your lower abdomen.

Correct answer: C

Rationale: The correct answer is to instruct the client to rotate the patch site each time they apply it. This practice helps prevent skin irritation and ensures the effectiveness of nitroglycerin transdermal patches. Applying the patch to the same site each time can lead to skin irritation and decreased patch efficacy. Choices A, B, and D are incorrect because applying the patch to the upper arm, removing it before showering, and placing it on the lower abdomen do not promote proper rotation of patch sites, which is essential for optimal outcomes.

2. A nurse is preparing to administer an IV medication to a client who reports a latex allergy. Which of the following actions should the nurse take?

• A. Place the client in a supine position.
• B. Use non-latex gloves when administering the medication.
• C. Use latex-free syringes when administering the medication.
• D. Administer the medication through a latex-free IV port.

Correct answer: D

Rationale: The correct action the nurse should take when preparing to administer an IV medication to a client with a latex allergy is to administer the medication through a latex-free IV port. This measure helps prevent allergic reactions in clients with a known latex allergy. Placing the client in a supine position (Choice A) is not directly related to preventing a latex allergy reaction. Using non-latex gloves (Choice B) is important for protecting the nurse or caregiver from latex exposure but does not prevent the client's allergic reaction. While using latex-free syringes (Choice C) is a good practice, ensuring the IV port is latex-free is more crucial in preventing an allergic response in the client.

3. A nurse is planning care for a client who is postoperative following a bowel resection. Which of the following interventions should the nurse include?

• A. Encourage the client to drink adequate fluids daily.
• B. Administer pain medication as needed.
• C. Instruct the client to splint the incision with a pillow.
• D. Encourage the client to eat a balanced diet.

Correct answer: C

Rationale: The correct intervention for a client post-bowel resection is to instruct the client to splint the incision with a pillow. This technique helps prevent dehiscence, which is the separation of wound edges, and reduces pain when coughing or moving. Splinting supports the incision site, decreasing tension on the wound. Encouraging the client to drink adequate fluids promotes hydration and aids in recovery, but a specific volume like 1,000 mL mentioned in choice A is not essential. Pain medication should be administered as needed for adequate pain control, not necessarily before every meal. Instructing the client to eat a balanced diet, including adequate protein, is crucial for wound healing and overall recovery, rather than limiting protein intake.

4. What is the best intervention for a patient with respiratory distress?

• A. Administer oxygen
• B. Administer bronchodilators
• C. Administer IV fluids
• D. Administer corticosteroids

Correct answer: A

Rationale: The correct answer is to administer oxygen. In respiratory distress, the priority intervention is to improve oxygenation. Administering oxygen helps increase the oxygen levels in the blood, supporting respiratory function. While bronchodilators may be used in specific respiratory conditions like asthma or COPD, they are not the primary intervention for respiratory distress. IV fluids are not indicated as the initial treatment for respiratory distress unless there is an underlying cause such as dehydration. Corticosteroids may be used in certain respiratory conditions to reduce inflammation, but they are not the first-line intervention for acute respiratory distress.

5. A nurse is reviewing the laboratory results of a client who has rheumatoid arthritis and is prescribed methotrexate. Which of the following results should the nurse report to the provider?

• A. White blood cell count 8,000/mm3
• B. Platelet count 150,000/mm3
• C. Hemoglobin 14 g/dL
• D. Aspartate aminotransferase (AST) 60 units/L

Correct answer: D

Rationale: The correct answer is D: Aspartate aminotransferase (AST) 60 units/L. An elevated AST level indicates liver damage, a side effect of methotrexate, and should be reported. Choices A, B, and C are within normal ranges and do not indicate potential complications related to methotrexate therapy.

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