Nursing Elites

1. A nurse is teaching a group of clients about stress management. Which of the following activities should the nurse recommend to reduce stress?

• A. Watching television
• B. Deep breathing exercises
• C. Drinking coffee
• D. Avoiding exercise

Correct answer: B

Rationale: Deep breathing exercises are effective in reducing stress by promoting relaxation and lowering heart rate, making them a recommended technique. Watching television may not actively reduce stress but can serve as a distraction. Drinking coffee, which contains caffeine, may increase anxiety levels. Avoiding exercise can lead to pent-up stress and tension rather than reducing it.

2. A nurse is caring for a client with a new prescription for enoxaparin to prevent DVT. Which of the following is an appropriate action by the nurse?

• A. Expel any air bubbles from the prefilled syringe
• B. Inject the medication in the lateral abdominal wall
• C. Massage the injection site to evenly distribute the medication
• D. Administer NSAIDs for injection site discomfort

Correct answer: B

Rationale: The correct answer is to inject enoxaparin in the lateral abdominal wall. This site is typically recommended for subcutaneous injections of this medication. Expelling air bubbles from prefilled syringes is not necessary and may result in medication loss. Massaging the injection site is contraindicated as it can cause bruising or hematoma formation. Administering NSAIDs for injection site discomfort is unnecessary and not a standard practice.

3. A nurse is caring for a client who is hyperventilating and has the following ABG results: pH 7.50, PaCO2 29 mm Hg, and HCO3- 25 mEq/L. The nurse should recognize that the client has which of the following acid-base imbalances?

• A. Respiratory acidosis
• B. Respiratory alkalosis
• C. Metabolic acidosis
• D. Metabolic alkalosis

Correct answer: B

Rationale: The correct answer is B: Respiratory alkalosis. In this scenario, the client is hyperventilating, leading to excessive elimination of carbon dioxide. As a result, the PaCO2 decreases, causing a decrease in hydrogen ion concentration and an increase in pH, resulting in respiratory alkalosis. Choice A, Respiratory acidosis, is incorrect because the ABG results show a low PaCO2, not an elevated one. Choices C and D, Metabolic acidosis and Metabolic alkalosis, do not align with the ABG results provided, which point towards a respiratory, not metabolic, imbalance.

4. When planning to discharge a client receiving home oxygen therapy, which of the following instructions should the nurse include in the discharge teaching?

• A. Ensure that electrical cords are not frayed
• B. Keep oxygen tanks in a horizontal position
• C. Store extra oxygen tanks in a closed closet
• D. Apply petroleum-based gel to the inside of the nostrils

Correct answer: A

Rationale: The correct answer is to ensure that electrical cords are not frayed. Frayed electrical cords pose a fire hazard when oxygen is in use. Keeping oxygen tanks in a horizontal position (Choice B) is important to prevent leaks but is not the priority compared to fire safety. Storing extra oxygen tanks in a closed closet (Choice C) is also important but not as immediate as preventing fire hazards. Applying petroleum-based gel to the inside of the nostrils (Choice D) is unrelated to oxygen therapy safety and is not recommended.

5. A nurse is preparing to administer IV furosemide. Which of the following should the nurse monitor for during the infusion?

• A. Increased urinary output
• B. Ototoxicity
• C. Hypokalemia
• D. Hypoglycemia

Correct answer: C

Rationale: The correct answer is C: Hypokalemia. Furosemide is a loop diuretic that works by increasing the excretion of water and electrolytes, particularly potassium. Therefore, the nurse should monitor for hypokalemia, as low potassium levels can lead to various complications such as cardiac dysrhythmias. Choice A, increased urinary output, is an expected effect of furosemide due to its diuretic action but is not a side effect needing monitoring. Ototoxicity (Choice B) is a potential adverse effect of other medications like aminoglycoside antibiotics, not furosemide. Hypoglycemia (Choice D) is not a common side effect associated with furosemide administration.

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