Nursing Elites

1. What is the best way to manage a patient's pain postoperatively?

• A. Administer analgesics regularly
• B. Administer pain medication PRN
• C. Encourage deep breathing exercises
• D. Provide distraction techniques

Correct answer: A

Rationale: The correct answer is A: Administer analgesics regularly. Postoperative pain management often requires a scheduled, around-the-clock administration of analgesics to maintain a consistent level of pain relief and minimize the risk of breakthrough pain. Choice B, administering pain medication PRN (as needed), may lead to inadequate pain control as the medication is not given preemptively. Choice C, encouraging deep breathing exercises, can be beneficial for pain management but should be used as an adjunct to analgesic therapy. Choice D, providing distraction techniques, may help some patients cope with pain but should not be the primary method of pain management postoperatively.

2. What is the priority nursing assessment for a patient with chronic kidney disease?

• A. Monitor serum creatinine
• B. Monitor blood pressure
• C. Monitor urine output
• D. Monitor potassium levels

Correct answer: A

Rationale: The correct answer is to monitor serum creatinine. In patients with chronic kidney disease, monitoring serum creatinine is crucial as it reflects kidney function. This assessment helps healthcare providers in evaluating the progression of the disease and adjusting treatment plans accordingly. Monitoring blood pressure (choice B) is essential in managing chronic kidney disease, but monitoring serum creatinine takes precedence. Monitoring urine output (choice C) and potassium levels (choice D) are also important aspects of managing chronic kidney disease, but they are not the priority assessment compared to monitoring serum creatinine.

3. A healthcare provider is preparing to administer an intramuscular injection to a client. Which of the following sites should the healthcare provider select?

• A. Deltoid
• B. Vastus lateralis
• C. Rectus femoris
• D. Dorsogluteal

Correct answer: B

Rationale: The vastus lateralis is the preferred site for intramuscular injections in adults due to its large muscle mass and low risk of complications. The deltoid, although a common site for vaccines, has a smaller muscle mass and may not be suitable for all types of medications. The rectus femoris is a muscle in the thigh that is more commonly used for intramuscular injections in infants. The dorsogluteal site is no longer recommended due to its proximity to major nerves and blood vessels.

4. A nurse is caring for a client following the application of a cast. Which of the following actions should the nurse take first?

• A. Place an ice pack over the cast
• B. Palpate the pulse distal to the cast
• C. Teach the client to keep the cast clean and dry
• D. Position the casted extremity on a pillow

Correct answer: B

Rationale: Palpating the pulse distal to the cast is the priority as it assesses for circulation. Ensuring adequate blood flow is essential to prevent complications such as compartment syndrome. Placing an ice pack over the cast could cause constriction of blood vessels, further compromising circulation. Teaching the client about cast care and positioning the casted extremity on a pillow are important but do not take precedence over assessing circulation.

5. A nurse is planning care for a client who has a stage 3 pressure injury. Which of the following interventions should the nurse include in the plan of care?

• A. Cleanse the wound with povidone-iodine solution daily.
• B. Irrigate the wound with hydrogen peroxide.
• C. Reposition the client every 4 hours.
• D. Use a moisture barrier ointment.

Correct answer: D

Rationale: The correct answer is to use a moisture barrier ointment. This intervention helps protect the skin and promote healing in clients with stage 3 pressure injuries. Cleansing the wound with povidone-iodine solution daily (Choice A) can be too harsh and may delay healing by damaging the surrounding skin. Irrigating the wound with hydrogen peroxide (Choice B) is not recommended as it can be cytotoxic to healing tissue. While repositioning the client every 4 hours (Choice C) is an essential intervention in preventing pressure injuries, it is not directly related to the care of an existing stage 3 pressure injury.

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