Nursing Elites

1. How should a healthcare provider respond to a patient experiencing a seizure?

• A. Protect the airway and monitor for post-ictal confusion
• B. Administer anticonvulsant medications
• C. Apply restraints to prevent injury
• D. Place the patient in a side-lying position

Correct answer: D

Rationale: When a patient is experiencing a seizure, the immediate priority is to ensure their safety by placing them in a side-lying position. This helps prevent aspiration in case of vomiting and maintains an open airway. Administering anticonvulsant medications is not within the scope of a healthcare provider's immediate response during a seizure. Applying restraints can potentially harm the patient by restricting movement and causing injury. Monitoring for post-ictal confusion is important after the seizure has ended, but the primary concern during the seizure is ensuring the patient's safety.

2. A healthcare provider is reviewing the medical record of a client who has coronary artery disease (CAD) and a prescription for aspirin. Which of the following findings should the healthcare provider report to the provider?

• A. History of gastrointestinal bleeding
• B. History of asthma
• C. History of liver disease
• D. History of hypertension

Correct answer: A

Rationale: A history of gastrointestinal bleeding is a critical finding to report to the healthcare provider because it is a contraindication for aspirin use in individuals with CAD. Aspirin can further increase the risk of bleeding in individuals with a history of gastrointestinal bleeding. Choices B, C, and D are not directly contraindications for aspirin use in this scenario. Asthma, liver disease, and hypertension are not typically contraindications for prescribing aspirin to patients with CAD.

3. During the admission of a client with a latex allergy, which of the following supplies has the potential to contain latex?

• A. Urinary catheters
• B. Indwelling catheters
• C. Sterile gloves
• D. Sterile gowns

Correct answer: A

Rationale: The correct answer is A: Urinary catheters. Urinary catheters often contain latex, which can trigger an allergic reaction in clients with latex allergy. Indwelling catheters (choice B), sterile gloves (choice C), and sterile gowns (choice D) can be latex-free alternatives. However, urinary catheters are more commonly made with latex, making them a higher risk for clients with latex allergies.

4. A nurse is caring for a client who has a chest tube following a thoracotomy. Which of the following findings should the nurse report to the provider?

• A. Drainage of 75 mL in the first hour after surgery.
• B. Constant bubbling in the water seal chamber.
• C. Tidaling in the water seal chamber.
• D. Client report of pain at the chest tube insertion site.

Correct answer: B

Rationale: Constant bubbling in the water seal chamber indicates an air leak, which should be reported to the provider. This finding suggests that the chest tube system is not functioning properly, leading to potential complications such as pneumothorax. Drainage of 75 mL in the first hour after surgery is within the expected range for a chest tube. Tidaling in the water seal chamber is a normal fluctuation and indicates proper functioning of the system. Client report of pain at the chest tube insertion site is expected after surgery and can be managed with appropriate pain management measures.

5. A nurse is caring for an infant who is receiving IV fluids for dehydration. Which of the following should the nurse recognize as a positive response to the therapy?

• A. Tachycardia
• B. Hypotension
• C. Increased urine output
• D. Diarrhea

Correct answer: C

Rationale: Increased urine output is a positive sign that the IV fluids are effectively treating dehydration. Tachycardia (choice A) and hypotension (choice B) are signs of dehydration and would not be considered positive responses to therapy. Diarrhea (choice D) can worsen dehydration and is not a positive response to IV fluid therapy.

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