Nursing Elites

1. The nurse is preparing to begin a medication regimen for a patient who will receive intravenous ampicillin and gentamicin. Which is an important nursing action?

• A. Administer each antibiotic to infuse over 15 to 20 minutes.
• B. Order serum peak and trough levels of ampicillin.
• C. Prepare the schedule so that the drugs are given at the same time.
• D. Set up separate tubing sets for each drug labeled with the drug name and date.

Correct answer: D

Rationale: When administering intravenous aminoglycosides like gentamicin with penicillins such as ampicillin, it is crucial to avoid mixing them in the same container. Separate tubing sets labeled with the drug name and date should be used to prevent interactions between the medications. Administering each antibiotic over 15 to 20 minutes (Choice A) may not be appropriate for all medications and does not address the issue of compatibility. Ordering serum peak and trough levels of ampicillin (Choice B) is important for monitoring drug levels but does not directly address the administration process. Preparing a schedule to give drugs simultaneously (Choice C) may increase the risk of drug interactions and is not recommended when administering incompatible medications.

2. If a client displays risk factors for coronary artery disease, such as smoking cigarettes, eating a diet high in saturated fat, or leading a sedentary lifestyle, techniques of behavior modification may be used to help the client change the behavior. The nurse can best reinforce new adaptive behaviors by:

• A. Explaining how the risk factor behaviors lead to poor health.
• B. Withholding praise until the new behavior is well established.
• C. Rewarding the client whenever the acceptable behavior is performed.
• D. Instilling mild fear in the client to extinguish the behavior.

Correct answer: C

Rationale: The correct answer is C. A fundamental principle of behavior modification is that behavior that is rewarded is more likely to be continued. Therefore, rewarding the client whenever the acceptable behavior is performed is the best approach to reinforce new adaptive behaviors. Choice A is incorrect because simply explaining how the risk factor behaviors lead to poor health may not be as effective in promoting behavior change compared to positive reinforcement. Choice B is incorrect because withholding praise can hinder progress and motivation for the client. Choice D is incorrect because instilling fear is not a recommended method in behavior modification. It can lead to negative psychological effects and is not a sustainable approach to behavior change.

3. A client has undergone renal angiography via the right femoral artery. The nurse determines that the client is experiencing a complication of the procedure upon noting:

• A. Urine output of 40 mL/hr
• B. Blood pressure of 118/76 mm Hg
• C. Respiratory rate of 18 breaths/min
• D. Pallor and coolness of the right leg

Correct answer: D

Rationale: Pallor and coolness of the right leg indicate a potential vascular complication following renal angiography, such as hemorrhage, thrombosis, or embolism. These signs suggest impaired circulation in the affected limb. Urine output, blood pressure, and respiratory rate are not typically associated with complications of renal angiography. Complications of this procedure mainly involve allergic reactions to the dye, dye-induced renal damage, and various vascular issues.

4. A nurse is assessing the status of a client with diabetes mellitus. The nurse concludes that the client is exhibiting adequate diabetic control if the serum level of glycosylated hemoglobin A1C (HbA1C) is less than:

• A. 7%
• B. 9%
• C. 10%
• D. 15%

Correct answer: A

Rationale: The correct answer is A: 7%. Glycosylated hemoglobin A1C (HbA1C) level of 7.0% or less is considered indicative of adequate diabetic control. This level reflects good long-term blood sugar management. Choices B, C, and D are incorrect because an HbA1C level above 7% indicates poor diabetic control and an increased risk of complications associated with diabetes, such as cardiovascular disease, neuropathy, and retinopathy.

5. What is the primary action of insulin in the body?

• A. To lower blood pressure.
• B. To promote the absorption of glucose into cells.
• C. To increase blood glucose levels.
• D. To decrease blood glucose levels.

Correct answer: B

Rationale: The correct answer is B: To promote the absorption of glucose into cells. Insulin facilitates the uptake of glucose by cells, thereby decreasing blood glucose levels. Choice A is incorrect as insulin does not directly affect blood pressure. Choice C is inaccurate as insulin works to lower, not increase, blood glucose levels. Choice D is incorrect because insulin's primary role is to lower, not increase, blood glucose levels by promoting glucose uptake into cells.

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