Nursing Elites

1. What is the initial action a healthcare provider should take for a patient with chest pain?

• A. Administer oxygen
• B. Administer nitroglycerin
• C. Administer morphine
• D. Prepare for surgery

Correct answer: A

Rationale: The correct initial action for a patient with chest pain is to administer oxygen. Chest pain can be caused by insufficient oxygenation, and providing oxygen helps alleviate the pain by increasing oxygen levels in the blood. Administering nitroglycerin or morphine may be appropriate based on the underlying cause of the chest pain, but oxygen should be given first to ensure the patient's oxygen supply is adequate. Surgery is not typically the initial intervention for chest pain.

2. A nurse is caring for a client who is 12 hr postpartum and has a third-degree perineal laceration. The client reports not having a bowel movement for 4 days. Which of the following medications should the nurse administer?

• A. Bisacodyl 10 mg rectal suppository.
• B. Magnesium hydroxide 30 ml PO.
• C. Famotidine 20 mg PO.
• D. Loperamide 4 mg PO.

Correct answer: A

Rationale: In this scenario, the nurse should administer Bisacodyl 10 mg rectal suppository. Bisacodyl is a stimulant laxative that promotes bowel movement, which is appropriate for a postpartum client experiencing constipation. Magnesium hydroxide (choice B) is an antacid and not indicated for constipation. Famotidine (choice C) is an H2 receptor antagonist used for reducing stomach acid production, not for constipation. Loperamide (choice D) is an antidiarrheal agent and would worsen constipation in this case.

3. A nurse is preparing an in-service for a group of nurses about malpractice issues in nursing. Which of the following examples should the nurse include in the teaching?

• A. Leaving a nasogastric tube clamped after administering oral medication.
• B. Documenting communication with a provider in the progress notes of the client's medical records.
• C. Administering potassium via IV bolus.
• D. Placing a yellow bracelet on a client who is at risk for falls.

Correct answer: C

Rationale: Administering potassium via IV bolus is a malpractice issue due to the risk of cardiac complications. Option A is incorrect as leaving a nasogastric tube clamped after administering oral medication can lead to complications but is not directly linked to malpractice. Option B is incorrect as documenting communication with a provider in the progress notes is a necessary part of nursing practice. Option D is incorrect as placing a yellow bracelet on a client at risk for falls is a safety measure to prevent falls and is not related to malpractice issues.

4. A nurse is caring for a client who is at 33 weeks of gestation following an amniocentesis. The nurse should monitor the client for which of the following complications?

• A. Vomiting.
• B. Hypertension.
• C. Epigastric pain.
• D. Contractions.

Correct answer: D

Rationale: Following an amniocentesis at 33 weeks of gestation, the nurse should monitor the client for contractions. Contractions can indicate preterm labor, which requires immediate attention. Vomiting, hypertension, and epigastric pain are not typically associated with amniocentesis complications at this gestational age.

5. A nurse is reviewing the laboratory values of a client who has diabetic ketoacidosis (DKA). Which of the following findings should the nurse report to the provider?

• A. Potassium 4.2 mEq/L
• B. Glucose 250 mg/dL
• C. Bicarbonate 20 mEq/L
• D. Sodium 135 mEq/L

Correct answer: B

Rationale: The correct answer is B. A glucose level of 250 mg/dL indicates hyperglycemia, which is expected in DKA. However, in the context of DKA management, persistent or worsening hyperglycemia can indicate inadequate treatment response or complications, necessitating further monitoring and intervention. Potassium levels are crucial in DKA due to the risk of hypokalemia, but a level of 4.2 mEq/L is within the normal range. Bicarbonate levels are typically low in DKA, making a value of 20 mEq/L consistent with the condition. Sodium levels of 135 mEq/L are also within normal limits and not a priority for immediate reporting in the context of DKA.

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