Nursing Elites

1. A client takes atorvastatin (Lipitor), with laboratory results showing a blood urea nitrogen (BUN) of 33 mg/dL and creatinine of 2.8 mg/dL. What action by the nurse is best?

• A. Ask if the client eats grapefruit.
• B. Assess the client for dehydration.
• C. Facilitate admission to the hospital.
• D. Obtain a random urinalysis.

Correct answer: A

Rationale: There is a drug-food interaction between statins and grapefruit that can lead to acute kidney failure. The client has elevated renal laboratory results, indicating kidney involvement. The nurse should ask if the client consumes grapefruit or grapefruit juice. While dehydration can elevate BUN, the increase in creatinine is more specific for kidney injury.

2. When teaching a group of clients about emergency care for a snake bite, which of the following information should the nurse include?

• A. Raise the affected extremity above the level of the heart.
• B. Immobilize the affected extremity with a splint
• C. Apply ice to the bite area
• D. Apply a tourniquet to the affected extremity.

Correct answer: B

Rationale: In cases of snake bites, it is essential to immobilize the affected extremity with a splint to prevent the spread of venom throughout the body. Raising the extremity above the heart level can promote venom spread, and applying ice or a tourniquet can worsen the condition. Immobilization helps reduce movement and slows the circulation of venom, aiding in the prevention of further complications.

3. A nurse is teaching a client who is obese and has obstructive sleep apnea how to decrease the number of nightly apneic episodes. Which of the following client statements indicates an understanding of the teaching?

• A. "It might help if I tried sleeping only on my back."
• B. "I'll sleep better if I take a sleeping pill at night."
• C. "I'll get a humidifier to run at my bedside at night."
• D. "If I could lose about 50 pounds, I might stop having so many apneic episodes."

Correct answer: D

Rationale:

4. A client was exposed to anthrax. Which of the following antibiotics should the nurse plan to administer?

• A. Ciprofloxacin
• B. Fluconazole
• C. Tobramycin
• D. Vancomycin

Correct answer: A

Rationale: In the case of anthrax exposure, the recommended antibiotic for prophylaxis and treatment is Ciprofloxacin. Ciprofloxacin is effective against the anthrax bacterium, Bacillus anthracis. Fluconazole is an antifungal medication, Tobramycin is an aminoglycoside antibiotic used for bacterial infections, and Vancomycin is a glycopeptide antibiotic primarily used for Gram-positive bacterial infections. Therefore, the correct choice is Ciprofloxacin.

5. A healthcare professional is interested in making interdisciplinary work a high priority. Which actions by the professional best demonstrate this skill? (Select ONE that does not apply)

• A. Consulting with other disciplines on client care
• B. Coordinating discharge planning for home safety
• C. Participating in comprehensive client rounding
• D. Sharing the care plans with other disciplines

Correct answer: B

Rationale: Interdisciplinary work in healthcare involves effective communication and collaboration between different disciplines for holistic client care. Consulting with other disciplines allows for sharing expertise, insights, and perspectives to enhance client outcomes. Participating in comprehensive client rounding involves a team-based approach to discuss and plan client care collectively. Sharing nursing care plans with other disciplines ensures that all team members are informed and can contribute to the client's overall well-being. Coordinating discharge planning is important but may not directly demonstrate interdisciplinary collaboration as the other actions do.

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