Nursing Elites

1. A nurse is teaching a prenatal class about infection prevention. Which of the following statements indicates an understanding of the teaching?

• A. I can visit someone with chickenpox 5 days after the sores crust.
• B. I should avoid cleaning my cat's litter box during pregnancy.
• C. I should wash my hands with hot water for 10 seconds after gardening.
• D. I can take antibiotics for viral infections.

Correct answer: B

Rationale: The correct answer is B because avoiding cleaning the cat's litter box during pregnancy reduces the risk of toxoplasmosis, which can be harmful to the developing fetus. Choice A is incorrect because visiting someone with chickenpox should be avoided as it is highly contagious. Choice C is incorrect as handwashing after gardening should involve soap and water, not just hot water, for effective infection prevention. Choice D is incorrect because antibiotics are ineffective against viral infections.

2. A healthcare professional is reviewing the medication history of a client who has a new prescription for warfarin. Which of the following medications should the healthcare professional identify as a contraindication for this client?

• A. Acetaminophen
• B. Ibuprofen
• C. Clopidogrel
• D. Metoprolol

Correct answer: C

Rationale: The correct answer is C, Clopidogrel. Clopidogrel is an antiplatelet medication that increases the risk of bleeding when taken with warfarin. Acetaminophen (choice A) and metoprolol (choice D) do not have significant interactions with warfarin. Ibuprofen (choice B) is an NSAID that can also increase the risk of bleeding when taken with warfarin, but clopidogrel is a more significant contraindication due to its antiplatelet effects. Therefore, healthcare professionals should be cautious when combining warfarin with clopidogrel due to the increased risk of bleeding compared to other options.

3. What is the most important nursing action when a patient has a central line?

• A. Monitor for infection
• B. Monitor the central line dressing
• C. Monitor for redness
• D. Monitor for swelling

Correct answer: A

Rationale: The most important nursing action when a patient has a central line is to monitor for infection. Central line-associated bloodstream infections are a serious complication that can lead to severe outcomes. Monitoring for infection involves assessing the patient for signs and symptoms such as fever, chills, and hypotension. While monitoring the central line dressing, redness, and swelling are also important aspects of care, they are secondary to monitoring for infection as the primary focus should be on preventing serious complications.

4. A healthcare professional is preparing to administer digoxin to a client with heart failure. Which of the following laboratory values should the professional report to the provider?

• A. Potassium 4.0 mEq/L
• B. Calcium 9.5 mg/dL
• C. Sodium 140 mEq/L
• D. Magnesium 2.0 mg/dL

Correct answer: C

Rationale: The correct answer is C: Sodium 140 mEq/L. An elevated sodium level can affect the effectiveness of digoxin therapy and may lead to toxicity. Therefore, it is crucial to report this value to the provider. Potassium, calcium, and magnesium levels are important as well, but elevated sodium can have a more direct impact on digoxin therapy in this scenario.

5. A nurse is assessing a client who is receiving opioid analgesics for pain management. Which of the following findings should the nurse report to the provider?

• A. Respiratory rate of 20/min
• B. Blood pressure of 118/76 mm Hg
• C. Heart rate of 88/min
• D. Oxygen saturation of 94%

Correct answer: C

Rationale: The correct answer is C. A heart rate of 88/min is a normal finding; therefore, it does not require immediate reporting to the provider. The respiratory rate of 20/min, blood pressure of 118/76 mm Hg, and oxygen saturation of 94% are also within normal ranges and do not indicate any immediate concerns. However, a serum potassium level of 3.0 mEq/L indicates hypokalemia, which can be a serious issue and should be reported to the provider for further evaluation and management.

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