Nursing Elites

1. A nurse is reviewing the medication orders for a client with heart failure. Which of the following medications should the nurse clarify with the provider?

• A. Furosemide
• B. Spironolactone
• C. Digoxin
• D. Ibuprofen

Correct answer: D

Rationale: The correct answer is D, Ibuprofen. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can worsen heart failure due to its effects on renal function and fluid retention. Therefore, the nurse should clarify the use of Ibuprofen with the provider. Choices A, B, and C (Furosemide, Spironolactone, and Digoxin) are commonly prescribed medications for heart failure that help manage symptoms and improve cardiac function, so they do not need clarification in this scenario.

2. What is a primary goal when managing a client with generalized anxiety disorder (GAD)?

• A. Encourage the client to engage in regular physical exercise
• B. Help the client avoid anxiety triggers through behavioral therapy
• C. Encourage the client to express feelings openly
• D. Teach relaxation techniques to help manage anxiety

Correct answer: D

Rationale: When managing a client with generalized anxiety disorder (GAD), a primary goal is to teach relaxation techniques to help manage anxiety. Relaxation techniques such as deep breathing, progressive muscle relaxation, and mindfulness can be effective in reducing anxiety symptoms. Encouraging the client to engage in regular physical exercise (Choice A) can be beneficial but teaching relaxation techniques is more specific to managing anxiety. Avoiding anxiety triggers through behavioral therapy (Choice B) may be part of the treatment plan but teaching relaxation techniques is more directly aimed at managing anxiety. While encouraging the client to express feelings openly (Choice C) can be important for overall emotional well-being, teaching relaxation techniques is more focused on addressing the symptoms of anxiety.

3. A nurse provides instructions to a client about preventing injury while using crutches. What should the nurse tell the client to avoid?

• A. An abnormal stance
• B. Injury to the nerves
• C. A fall and further injury
• D. Skin breakdown

Correct answer: B

Rationale: The correct answer is B: Injury to the nerves. Resting the underside of the arm on the crutch pad can injure the nerves. Choice A, an abnormal stance, is not directly related to nerve injury while using crutches. Choice C, a fall and further injury, is a general risk associated with improper crutch use but does not specifically address nerve injury. Choice D, skin breakdown, is a concern related to pressure ulcers but not the primary focus when discussing injury prevention related to crutch use.

4. A client is prescribed 1g of potassium phosphate IV to be infused continuously over 6 hr. Available is 1 g in 250 ml of dextrose 5%. What rate should the nurse set the IV pump to run at?

• A. 40 ml/hr
• B. 42 ml/hr
• C. 44 ml/hr
• D. 46 ml/hr

Correct answer: B

Rationale: To calculate the IV rate, divide the total volume by the total time in hours. In this case, 1 g in 250 ml is to be infused over 6 hours. Therefore, 250 ml / 6 hr = 42 ml/hr. This means the IV pump should be set to run at 42 ml/hr. Choices A, C, and D are incorrect as they do not accurately calculate the infusion rate based on the provided information.

5. What are the important considerations when administering blood products to a patient?

• A. Ensuring proper documentation of the transfusion
• B. Verifying the patient's identity before administration
• C. Monitoring for allergic reactions or transfusion reactions
• D. Monitoring the patient's vital signs during transfusion

Correct answer: B

Rationale: Verifying the patient's identity before administration is a critical step to ensure that the correct blood product is given to the right patient, thereby preventing transfusion errors. While ensuring proper documentation of the transfusion (choice A) is important for record-keeping, verifying patient identity (choice B) directly addresses the risk of administering blood to the wrong patient. Monitoring for allergic reactions or transfusion reactions (choice C) and monitoring the patient's vital signs during transfusion (choice D) are also essential considerations during blood product administration, but verifying patient identity takes precedence to prevent potentially life-threatening errors.

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