Nursing Elites

1. A patient receiving chemotherapy has developed neutropenia. What should be included in the care plan to reduce infection risk?

• A. Monitor temperature daily
• B. Limit visitors
• C. Administer antibiotics prophylactically
• D. Use reverse isolation precautions

Correct answer: D

Rationale: When a patient receiving chemotherapy develops neutropenia, the priority is to reduce the risk of infection. Using reverse isolation precautions is crucial in this situation to protect the patient from exposure to pathogens. Monitoring temperature daily (Choice A) is important but is not as effective as isolating the patient. Limiting visitors (Choice B) can help reduce the risk of exposure, but reverse isolation is a more stringent measure. Administering antibiotics prophylactically (Choice C) is not recommended unless there is a specific indication, as it can contribute to antibiotic resistance.

2. A client with a DNR order has requested resuscitation during a visit from the family. What is the nurse's best course of action?

• A. Follow the family's request and perform CPR.
• B. Explain to the family that the DNR must be honored.
• C. Call the healthcare provider to cancel the DNR order.
• D. Delay resuscitation until further clarification can be made.

Correct answer: B

Rationale: The correct course of action for the nurse is to explain to the family that the DNR (Do Not Resuscitate) order must be honored. It is essential for the nurse to uphold the client's wishes as documented in the DNR order. Performing CPR against the client's expressed wishes in the DNR order would violate ethical and legal standards. Calling the healthcare provider to cancel the DNR order without the client's consent is inappropriate and goes against the client's autonomy. Delaying resuscitation can be detrimental in an emergency situation and may not align with the client's wishes as outlined in the DNR order.

3. A nurse at a provider's office is providing teaching to a client who is taking chemotherapy and losing weight. Which of the following should the nurse recommend to increase calorie and protein intake? (SATA)

• A. Top fruits with yogurt
• B. Add cream to soups
• C. Increase fluids during meals
• D. Use milk instead of water in recipes

Correct answer: A

Rationale: Topping fruits with yogurt is the correct recommendation to increase calorie and protein intake for a client on chemotherapy who is losing weight. Yogurt is a good source of protein and adding it to fruits can provide additional calories as well. Choice B, adding cream to soups, may increase calorie intake but does not specifically address protein needs. Choice C, increasing fluids during meals, is important for hydration but does not directly address calorie and protein intake. Choice D, using milk instead of water in recipes, may increase calorie content but does not focus on increasing protein intake, which is essential for clients on chemotherapy.

4. A client with a urinary tract infection is prescribed ciprofloxacin. Which instruction should the nurse provide?

• A. Continue taking this medication until you feel better
• B. Take this medication with milk or food
• C. Take the medication with an antacid
• D. Avoid caffeine while taking this medication

Correct answer: D

Rationale: The correct instruction for the nurse to provide to a client taking ciprofloxacin for a urinary tract infection is to avoid caffeine. Ciprofloxacin can interact with caffeine, potentially leading to increased side effects or reduced effectiveness. Choice A is incorrect because antibiotics should be taken for the full prescribed course, even if the client starts feeling better. Choice B is incorrect as ciprofloxacin should not be taken with dairy products or antacids as they can interfere with the absorption of the medication.

5. A nurse is assessing a client who has heart failure and is taking digoxin. The nurse should monitor the client for which of the following manifestations as an indication of digoxin toxicity to report to the provider?

• A. Diarrhea
• B. Vomiting
• C. Ringing in ears
• D. Dizziness

Correct answer: B

Rationale: The correct answer is B: Vomiting. Vomiting is a common sign of digoxin toxicity and should be reported to the healthcare provider. Diarrhea (Choice A) is a more common side effect of digoxin but not typically associated with toxicity. Ringing in the ears (Choice C) is a potential sign of toxicity; however, vomiting is a more immediate concern. Dizziness (Choice D) can occur with digoxin use but is not a specific indicator of toxicity.

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