Nursing Elites

1. What is the first medication to give to a patient with an allergic reaction causing wheezing?

• A. Albuterol 3 ml via nebulizer
• B. Methylprednisolone 100 mg IV
• C. Cromolyn 20 mg via nebulizer
• D. Aminophylline 500 mg IV

Correct answer: A

Rationale: The correct answer is A, Albuterol 3 ml via nebulizer. Albuterol is a fast-acting bronchodilator that helps relieve wheezing by relaxing the muscles in the airways, making it the first-line treatment for wheezing caused by bronchospasms in allergic reactions. Methylprednisolone (Choice B) is a corticosteroid used for its anti-inflammatory properties and is typically given after bronchodilators. Cromolyn (Choice C) is a mast cell stabilizer that is used for the prevention of asthma symptoms, not for immediate relief. Aminophylline (Choice D) is a bronchodilator that is less commonly used nowadays due to its narrow therapeutic window and potential for toxicity.

2. What dietary teaching should be provided to a patient with GERD?

• A. Avoid mint and pepper
• B. Consume liquids with meals
• C. Increase fluid intake with meals
• D. Eat large meals before bed

Correct answer: A

Rationale: The correct dietary teaching for a patient with GERD is to avoid mint and pepper. Mint and pepper can trigger reflux symptoms and increase gastric acid secretion, exacerbating GERD. Choices B and C are not recommended for patients with GERD as consuming liquids with meals and increasing fluid intake during meals can contribute to reflux by distending the stomach. Choice D, eating large meals before bed, can also worsen GERD symptoms by increasing pressure on the lower esophageal sphincter and promoting reflux.

3. A nurse is assessing a client who has a heart rate of 40/min. The client is diaphoretic and has chest pain. Which of the following medications should the nurse plan to administer?

• A. Lidocaine
• B. Adenosine
• C. Atropine
• D. Verapamil

Correct answer: C

Rationale: The correct answer is C: Atropine. The client's presentation of bradycardia, diaphoresis, and chest pain indicates reduced cardiac output, requiring intervention to increase the heart rate. Atropine is used to treat bradycardia by blocking cardiac muscarinic receptors, thus inhibiting the parasympathetic nervous system. Lidocaine (Choice A) is used for ventricular arrhythmias, not bradycardia. Adenosine (Choice B) is used for supraventricular tachycardia, not bradycardia. Verapamil (Choice D) is a calcium channel blocker used for certain arrhythmias and hypertension, but not for increasing heart rate in bradycardia.

4. A client is to undergo a liver biopsy. Which of the following instructions should the nurse provide to the client following the procedure?

• A. Lie on your left side.
• B. Lie on your right side.
• C. Increase your fluid intake.
• D. Decrease your fluid intake.

Correct answer: B

Rationale: After a liver biopsy, the nurse should instruct the client to lie on the right side. This position helps apply pressure to the biopsy site, promoting hemostasis and reducing the risk of bleeding. Lying on the left side may not provide adequate pressure to the site. Increasing fluid intake is generally beneficial to prevent dehydration and aid in the recovery process, whereas decreasing fluid intake could lead to dehydration and possible complications. Therefore, the correct instruction is to lie on the right side.

5. What are the expected symptoms in a patient experiencing a thrombotic stroke?

• A. Gradual loss of function on one side of the body
• B. Sudden loss of consciousness
• C. Seizures and convulsions
• D. Severe headache and vomiting

Correct answer: A

Rationale: The correct answer is A: 'Gradual loss of function on one side of the body.' Thrombotic strokes typically result in a gradual onset of symptoms due to a blockage in a blood vessel in the brain, leading to a slow progression of neurological deficits. Choices B, C, and D are incorrect because sudden loss of consciousness, seizures, convulsions, severe headache, and vomiting are more commonly associated with other types of strokes or medical conditions, such as hemorrhagic strokes, epilepsy, or migraines.

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