Nursing Elites

1. A patient with a history of osteoporosis is prescribed alendronate (Fosamax). What specific instructions should the nurse provide to ensure the effectiveness of the medication?

• A. Take the medication with a full glass of water and remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption.
• B. Take the medication with milk to enhance calcium absorption.
• C. Take the medication at bedtime to ensure absorption during sleep.
• D. Take the medication with food to prevent nausea.

Correct answer: A

Rationale: The correct answer is A. Alendronate should be taken with a full glass of water, and patients should remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption. This positioning helps reduce the risk of esophageal irritation and ensures adequate drug absorption. Choice B is incorrect because alendronate should be taken with water, not milk. Choice C is incorrect as there is no specific advantage to taking alendronate at bedtime. Choice D is incorrect because taking alendronate with food may interfere with its absorption.

2. A 45-year-old client is admitted with new-onset status epilepticus. What is the priority nursing intervention?

• A. Administer IV fluids and monitor electrolytes.
• B. Administer antiepileptic medications as prescribed.
• C. Ensure a patent airway and prepare for possible intubation.
• D. Monitor the client for signs of hypotension.

Correct answer: C

Rationale: The correct answer is C. In a client with new-onset status epilepticus, the priority nursing intervention is to ensure a patent airway and prepare for possible intubation. This is crucial to prevent hypoxia and further complications. Administering IV fluids and monitoring electrolytes (choice A) can be important but ensuring airway patency takes precedence. Administering antiepileptic medications (choice B) is essential but only after securing the airway. Monitoring for hypotension (choice D) is also important but not the priority when managing status epilepticus.

3. When teaching a patient starting on oral contraceptives, what should the nurse include regarding the medication's effectiveness?

• A. Oral contraceptives are 100% effective when taken correctly.
• B. Oral contraceptives are effective immediately after starting.
• C. Oral contraceptives are less effective if taken with certain antibiotics.
• D. Oral contraceptives are less effective if taken with food.

Correct answer: C

Rationale: The correct answer is C. Oral contraceptives can be less effective when taken with certain antibiotics as they may interfere with the effectiveness of the contraceptive. It is important for patients to be aware of this interaction to consider additional contraceptive methods during antibiotic therapy. Choices A and B are incorrect as no contraceptive method is 100% effective, and oral contraceptives typically require a period of time to reach full effectiveness. Choice D is incorrect as taking oral contraceptives with food does not significantly impact their effectiveness.

4. Joseph, a 12-year-old child, complains to the school nurse about nausea and dizziness. While assessing the child, the nurse notices a black eye that looks like an injury. This is the third time in 1 month that the child has visited the nurse. Each time, the child provides vague explanations for various injuries. Which of the following is the school nurse’s priority intervention?

• A. Contact the child’s parents and ask about the child’s injuries.
• B. Encourage the child to be honest about the injuries.
• C. Question the teacher about the child's injuries.
• D. Report suspicion of abuse to the proper authorities.

Correct answer: D

Rationale: The school nurse's priority intervention in this situation is to report suspicion of abuse to the proper authorities. Given the pattern of unexplained injuries and vague explanations provided by the child, it raises significant concerns for possible abuse. Reporting to the appropriate authorities is crucial to ensure the child's safety and well-being. Contacting the child's parents (Choice A) may not be appropriate if abuse is suspected, as it could potentially put the child at further risk. Merely encouraging the child to be honest (Choice B) does not address the immediate safety concerns. Questioning the teacher (Choice C) is not the appropriate initial action when abuse is suspected; reporting to authorities should take precedence.

5. After a 27-year-old woman with epilepsy had a generalized seizure, she feels tired and falls asleep. This is:

• A. an ominous sign.
• B. normal and termed the postictal period.
• C. a reflection of an underlying brain tumor.
• D. only worrisome if there are focal neurologic deficits after.

Correct answer: B

Rationale: The correct answer is B: normal and termed the postictal period. The postictal period is a common phase following a seizure where the individual may experience fatigue, confusion, or sleepiness. It is a normal part of the seizure event and does not necessarily indicate a serious issue. Choice A is incorrect because feeling tired and falling asleep after a seizure is not an ominous sign but rather a typical postictal symptom. Choice C is incorrect as there is no indication in the scenario provided that links the symptoms to an underlying brain tumor. Choice D is incorrect because the absence of focal neurologic deficits does not make the postictal period worrisome.

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