Nursing Elites

1. A nurse is reviewing the medical record of a client who has osteomyelitis and a prescription for gentamicin IV every 8 hours. Which of the following serum laboratory results should the nurse report to the provider before administering the gentamicin?

• A. Hematocrit 45%
• B. Sodium 140 mEq/L
• C. Creatinine 2.4 mg/dL
• D. Potassium 4.0 mEq/L

Correct answer: C

Rationale: An elevated creatinine level indicates potential kidney dysfunction, which is crucial when administering gentamicin as it can be nephrotoxic. Reporting a high creatinine level to the provider is essential to prevent further kidney damage. Choice A (Hematocrit 45%) is within the normal range and not directly related to gentamicin administration. Choice B (Sodium 140 mEq/L) and Choice D (Potassium 4.0 mEq/L) are also within normal limits and do not directly impact the administration of gentamicin.

2. The nurse is evaluating a client who had a cardiac catheterization with a left antecubital insertion site. Which of the following pulses should the nurse palpate?

• A. Brachial pulse in the right arm
• B. Radial pulse in the right arm
• C. Brachial pulse in the left arm
• D. Radial pulse in the left arm

Correct answer: D

Rationale: The correct answer is to palpate the radial pulse in the left arm. When the antecubital insertion site is on the left side, it is important to assess the radial pulse on the same side to monitor circulation accurately. Palpating the brachial pulse in the right or left arm or the radial pulse in the right arm would not provide direct information about the circulation related to the catheterization site.

3. Which nursing action will best promote patient safety when administering medications?

• A. Check the patient's wristband before administering medications.
• B. Confirm the patient's allergies prior to administration.
• C. Document the medications immediately after administration.
• D. Prepare medications at the medication cart to minimize distractions.

Correct answer: B

Rationale: Confirming the patient's allergies before administering medications is crucial for patient safety as it helps prevent adverse reactions. Checking the patient's wristband is important for identification but may not directly impact medication safety. Documenting medications after administration is necessary but does not primarily promote safety during administration. Preparing medications at the medication cart, rather than the nurse's station, is preferred to ensure accuracy and proper medication handling, but it is not directly related to confirming allergies for safety.

4. What is a key component of a comprehensive discharge plan for a patient with heart failure?

• A. Advising on appropriate physical activity and exercise
• B. Fluid restriction to prevent fluid overload
• C. Dietary recommendations, including a low-sodium diet
• D. Medication management, including diuretics and ACE inhibitors

Correct answer: A

Rationale: The main components of a comprehensive discharge plan for a patient with heart failure include advising on appropriate physical activity and exercise to improve cardiovascular health and overall well-being. While fluid restriction and dietary recommendations are important aspects of heart failure management, advising on physical activity and exercise is crucial for improving cardiac function and quality of life post-discharge. Medication management is also essential but focusing on physical activity is particularly relevant for long-term management and preventing readmissions.

5. A patient with a urinary tract infection (UTI) requires treatment. What is the most appropriate intervention?

• A. Encourage the patient to increase fluid intake.
• B. Administer antibiotics as prescribed.
• C. Recommend the patient take over-the-counter pain relievers.
• D. Encourage the patient to limit physical activity.

Correct answer: B

Rationale: The correct answer is to administer antibiotics as prescribed. Antibiotics are the primary treatment for urinary tract infections as they help eliminate the bacteria causing the infection. Encouraging the patient to increase fluid intake (Choice A) is a supportive measure to help flush out the bacteria but doesn't directly treat the infection. Over-the-counter pain relievers (Choice C) may help with discomfort but do not address the underlying infection. Limiting physical activity (Choice D) may be recommended for some conditions but is not the primary intervention for treating a UTI.

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