Nursing Elites

1. A client with tuberculosis is about to start combination drug therapy. Which of the following medications should the nurse plan to administer? (SATA)

• A. Acyclovir
• B. Pyrazinamide
• C. Isoniazid
• D. Rifampin

Correct answer: B

Rationale: The correct answer is B: Pyrazinamide. In the treatment of tuberculosis, a combination drug therapy is usually employed. Pyrazinamide and rifampin are two key drugs used in this regimen. Acyclovir is an antiviral medication used for herpes infections, not for tuberculosis. Isoniazid is another medication used in tuberculosis treatment, but in this case, the question asked for medications to administer, and the correct choices should be those commonly used in tuberculosis combination therapy.

2. Which of the following is a critical nursing action when managing a patient with a chest tube?

• A. Keep the chest tube clamped at all times.
• B. Ensure the chest tube is connected to a closed drainage system.
• C. Empty the chest tube drainage system every 2 hours.
• D. Disconnect the chest tube when the patient is ambulating.

Correct answer: B

Rationale: The correct answer is B: "Ensure the chest tube is connected to a closed drainage system." This is a critical nursing action when managing a patient with a chest tube because it is essential for proper drainage and to prevent complications such as air leaks or infections. Option A is incorrect because keeping the chest tube clamped at all times would prevent proper drainage and could lead to complications. Option C is incorrect as emptying the chest tube drainage system should be done based on assessment findings rather than a fixed time interval. Option D is incorrect because disconnecting the chest tube when the patient is ambulating can lead to complications like a pneumothorax.

3. A client is vomiting, and a nurse is providing care. Which of the following actions should the nurse take first?

• A. Administer an antiemetic to the client
• B. Notify housekeeping
• C. Prevent the client from aspirating
• D. Provide the client with an emesis basin

Correct answer: C

Rationale: Preventing aspiration is the priority when caring for a client who is vomiting to reduce the risk of pneumonia or other respiratory complications. Aspiration can occur when vomitus enters the airway, leading to respiratory distress. Ensuring the airway is protected during vomiting episodes is essential. Administering an antiemetic (Choice A) can be considered after addressing the immediate risk of aspiration. Notifying housekeeping (Choice B) and providing an emesis basin (Choice D) are important but are secondary to preventing aspiration, which is crucial for the client's safety and well-being.

4. A healthcare provider orders a medication dose three times higher than usual. What is the nurse's first step?

• A. Administer the medication but monitor the patient closely.
• B. Verify the dosage with the prescribing provider.
• C. Administer a lower dose to minimize the risk.
• D. Hold the medication and wait for further clarification.

Correct answer: B

Rationale: The correct answer is B: Verify the dosage with the prescribing provider. When faced with an unusual medication dose, the nurse's initial action should be to confirm the order with the healthcare provider who prescribed it. This step is crucial to prevent medication errors and ensure patient safety. Choices A, C, and D are incorrect because administering the medication without clarification, administering a lower dose without approval, or holding the medication without consulting the provider can all pose risks to the patient's well-being.

5. A client with a new diagnosis of type 1 diabetes mellitus is being taught about self-administration of insulin by a nurse. Which of the following instructions should the nurse include?

• A. Store the current bottle of insulin at room temperature
• B. Massage the injection site after removing the needle
• C. Pull back on the plunger after injecting the insulin
• D. Use each syringe up to six times

Correct answer: A

Rationale: The correct answer is to store the current bottle of insulin at room temperature. Insulin should be stored this way to maintain its potency and effectiveness. Choice B is incorrect because massaging the injection site after removing the needle is not recommended practice and can cause bruising. Choice C is incorrect as pulling back on the plunger after injecting insulin can lead to injecting air bubbles into the tissue. Choice D is incorrect as syringes should not be reused multiple times due to the risk of contamination and inaccurate dosing.

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