Nursing Elites

1. What is the appropriate intervention for a patient with hypertension refusing medication?

• A. Educate the patient on the importance of medication
• B. Respect the patient's decision
• C. Inform the healthcare provider
• D. Explore alternative treatment options

Correct answer: A

Rationale: The correct answer is A: Educate the patient on the importance of medication. Providing education to the patient is crucial in promoting understanding of the condition and the necessity of medication. By enhancing the patient's knowledge, healthcare providers can empower them to make informed decisions regarding their health. Choice B, respecting the patient's decision, may not be appropriate in this scenario as untreated hypertension can lead to serious complications. Choice C, informing the healthcare provider, is important but should be done after attempting to educate the patient. Choice D, exploring alternative treatment options, may be considered if the patient has concerns or side effects related to the medication, but initially, educating the patient about the importance of medication is key.

2. A client prescribed clozapine is receiving discharge teaching from a nurse. Which statement by the client indicates an understanding of the teaching?

• A. “I should report a sore throat to my provider.”
• B. “I should avoid drinking grapefruit juice while taking this medication.”
• C. “I should take this medication with food.”
• D. “I should avoid taking this medication with food.”

Correct answer: A

Rationale: The correct answer is A. Clozapine can cause agranulocytosis, a serious condition that decreases the number of white blood cells. Reporting a sore throat is crucial as it could be a sign of infection. Choice B is incorrect because there is no specific interaction between clozapine and grapefruit juice. Choice C is incorrect because clozapine is usually taken without regard to meals. Choice D is incorrect as clozapine is generally taken without food to enhance absorption.

3. A nurse is reviewing the medical record of a client who has chronic kidney disease. The client's potassium level is 6.5 mEq/L. Which of the following actions should the nurse take?

• A. Administer sodium bicarbonate
• B. Administer sodium polystyrene sulfonate
• C. Administer calcium gluconate
• D. Administer calcium carbonate

Correct answer: B

Rationale: The correct answer is B: Administer sodium polystyrene sulfonate. Sodium polystyrene sulfonate is used to treat hyperkalemia by promoting the excretion of potassium. Choice A, administering sodium bicarbonate, is incorrect as it is not used to treat hyperkalemia. Choice C, administering calcium gluconate, is incorrect as it is used to treat hypocalcemia, not hyperkalemia. Choice D, administering calcium carbonate, is incorrect as it is used to treat conditions like osteoporosis and indigestion, not hyperkalemia.

4. A nurse is planning care for a client who is receiving hemodialysis. Which of the following actions should the nurse include in the plan of care?

• A. Withhold all medications until after dialysis.
• B. Rehydrate with dextrose 5% in water for orthostatic hypotension.
• C. Check the vascular access site for bleeding after dialysis.
• D. Give an antibiotic 30 minutes before dialysis.

Correct answer: C

Rationale: The correct action the nurse should include in the plan of care for a client receiving hemodialysis is to check the vascular access site for bleeding after dialysis. This is crucial to detect any bleeding complications and ensure prompt intervention if necessary. Withholding all medications until after dialysis (Choice A) is not appropriate as some medications may need to be administered during dialysis. Rehydrating with dextrose 5% in water for orthostatic hypotension (Choice B) is not directly related to the immediate post-dialysis care. Giving an antibiotic 30 minutes before dialysis (Choice D) is not recommended as timing of medication administration should be based on the specific antibiotic and its pharmacokinetics.

5. A nurse is assessing a client who has chronic obstructive pulmonary disease (COPD). Which of the following findings should the nurse expect?

• A. Increased oxygen saturation with exercise.
• B. Pursed-lip breathing with exertion.
• C. Productive cough with clear sputum.
• D. Clubbing of the fingers.

Correct answer: C

Rationale: The correct answer is C: 'Productive cough with clear sputum.' Clients with COPD often have a chronic productive cough with thick, often purulent sputum. This sputum can be white, yellow, green, or clear. Choices A, B, and D are incorrect. Oxygen saturation may decrease with exertion in COPD due to impaired gas exchange. Pursed-lip breathing is used to control dyspnea, not directly related to increased saturation with exercise. Clubbing of the fingers is typically seen in conditions such as cyanotic heart disease or lung cancer.

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