Nursing Elites

1. A healthcare professional is teaching a client about the use of methotrexate. Which of the following should be included?

• A. It is a pain reliever
• B. Monitor for signs of infection
• C. It can be taken without food
• D. It is safe to use during pregnancy

Correct answer: B

Rationale: The correct answer is B: 'Monitor for signs of infection.' Methotrexate can suppress the immune system, making the client more susceptible to infections. Educating the client to monitor for signs of infection is crucial for early detection and management. Choice A is incorrect because methotrexate is not a pain reliever; it is commonly used to treat conditions like cancer, rheumatoid arthritis, and psoriasis. Choice C is incorrect because methotrexate is usually recommended to be taken with food to reduce gastrointestinal side effects. Choice D is incorrect because methotrexate is known to be harmful during pregnancy and should not be used by pregnant individuals as it can cause birth defects.

2. A nurse is preparing to administer a dose of enoxaparin. Which of the following actions should the nurse take?

• A. Administer it intramuscularly
• B. Monitor APTT levels
• C. Give it in the abdomen
• D. Administer rapidly

Correct answer: C

Rationale: The correct answer is to give enoxaparin in the abdomen. Enoxaparin is usually administered subcutaneously in the abdomen to avoid muscle irritation. Choice A is incorrect because enoxaparin should not be administered intramuscularly. Choice B is incorrect as monitoring APTT levels is not directly related to administering enoxaparin. Choice D is incorrect as enoxaparin should be administered slowly to prevent bruising or bleeding at the injection site.

3. A nurse is caring for a client who has an indwelling urinary catheter. What should the nurse identify as a catheter occlusion?

• A. Pain during urination
• B. Bladder distention
• C. Cloudy urine
• D. Blood in the catheter tube

Correct answer: B

Rationale: The correct answer is B: Bladder distention. Bladder distention indicates that the bladder is full and there is impaired elimination, which could be caused by catheter occlusion. Pain during urination (choice A) is not typically associated with catheter occlusion but may indicate a urinary tract infection. Cloudy urine (choice C) can be a sign of infection but is not specific to catheter occlusion. Blood in the catheter tube (choice D) may indicate trauma during catheter insertion but is not a typical finding in catheter occlusion.

4. A nurse is caring for a client who has mild anxiety. Which of the following findings should the nurse expect?

• A. Feelings of dread
• B. Rapid speech
• C. Purposeless activity
• D. Heightened perceptual field

Correct answer: D

Rationale: In mild anxiety, the client is expected to have a heightened perceptual field. This means that their perception is increased, enhancing their awareness and ability to concentrate. Feelings of dread (Choice A) are more common in moderate to severe anxiety. Rapid speech (Choice B) and purposeless activity (Choice C) are more indicative of moderate to severe anxiety where the individual may exhibit signs of agitation and restlessness.

5. A nurse is planning care for four clients. Which client is the highest priority?

• A. Client with dry, black eschar on the heel
• B. Client wearing an arm cast and reporting numb fingers
• C. Client with reddened skin around the coccyx
• D. Client with frequent incontinence

Correct answer: B

Rationale: The correct answer is B because numb fingers indicate neurovascular compromise, which can lead to serious complications if not addressed promptly. The priority in this situation is to assess and address any circulation issues affecting the extremity. Choices A, C, and D are of concern but not as immediate as neurovascular compromise, which requires urgent attention to prevent further complications.

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