Nursing Elites

1. What safety measure should be implemented when administering chemotherapy?

• A. Use protective gloves and gown
• B. Prepare the medication in a designated area
• C. Administer the medication at the appropriate rate
• D. Verify the two client identifiers

Correct answer: A

Rationale: When administering chemotherapy, it is crucial to use protective gloves and a gown to protect against exposure to hazardous drugs that can be harmful through skin contact. Choice B is incorrect because chemotherapy medication should be prepared in a designated area to prevent contamination and ensure accurate preparation. Choice C is incorrect as chemotherapy should be administered at the appropriate rate to ensure patient safety and avoid adverse effects. Choice D is incorrect as verifying client identifiers is important for medication administration in general but not a specific safety measure related to chemotherapy administration.

2. A new father asks the nurse the reason for placing an ophthalmic ointment in his newborn's eyes. What information should the nurse provide?

• A. Possible exposure to an environmental staphylococcus infection can infect the newborn's eyes and cause visual deficits
• B. The newborn is at risk for blindness from a corneal syphilitic infection acquired from a mother's infected vagina
• C. Treatment prevents tear duct obstruction with harmful exudate from a vaginal birth that can lead to dry eyes in the newborn
• D. State law mandates all newborns receive prophylactic treatment to prevent gonorrheal or chlamydial ophthalmic infection

Correct answer: D

Rationale: The correct answer is D because informing about state law emphasizes the legal requirement and public health rationale behind prophylactic eye treatment to prevent serious infections like gonorrheal or chlamydial ophthalmic infection. Choices A, B, and C are incorrect. Choice A focuses on staphylococcus infection, which is not the primary concern addressed by the prophylactic ointment. Choice B mentions a specific infection acquired from the mother's infected vagina, which is not the main reason for the ophthalmic ointment. Choice C discusses tear duct obstruction and dry eyes, which are not the primary concerns addressed by the prophylactic ointment.

3. A terminally ill male client and his family request hospice care after discharge. What aspect of care should the nurse indicate is the focus of hospice?

• A. Enhance symptom management to improve end-of-life quality
• B. Facilitate assisted suicide with the client's consent
• C. Offer ways to postpone the death experience at home
• D. Provide training for family members to care for the client

Correct answer: A

Rationale: The correct answer is A. Hospice care focuses on enhancing symptom management to improve the end-of-life quality for terminally ill patients and their families. Hospice aims to provide comfort, dignity, and support during the end-of-life journey. Choice B is incorrect as hospice care does not involve assisted suicide but focuses on providing palliative care. Choice C is incorrect as hospice care does not aim to postpone the death experience but rather to provide support and comfort during this time. Choice D is incorrect as while hospice care may involve educating family members on caring for the client, the primary focus is on symptom management and quality of life.

4. The client with high blood pressure is being taught by the nurse to avoid adding salt during cooking. What effect does sodium have on blood pressure?

• A. It decreases the viscosity of blood
• B. It leads to increased fluid retention
• C. It causes vasoconstriction of the blood vessels
• D. It enhances the excretion of potassium

Correct answer: C

Rationale: The correct answer is C: 'It causes vasoconstriction of the blood vessels.' Sodium can lead to vasoconstriction, which narrows the blood vessels, increasing resistance to blood flow and subsequently raising blood pressure. Choices A, B, and D are incorrect. Sodium does not decrease blood viscosity, but it can lead to fluid retention, which increases blood volume and pressure. It does not enhance the excretion of potassium; instead, high sodium intake can lead to potassium excretion by the kidneys.

5. While caring for a client who is being mechanically ventilated, the nurse responds to a high-pressure alarm on the ventilator. Which assessment finding warrants immediate intervention by the nurse?

• A. Endotracheal cuff pressure greater than 25 cm H2O.
• B. Decreased lung compliance during ventilation.
• C. Bilateral crackles with increased secretions.
• D. Restless client who is biting the endotracheal tube.

Correct answer: D

Rationale: A restless client biting the endotracheal tube can increase airway resistance, triggering the high-pressure alarm and indicating a need for immediate intervention. This behavior can lead to complications such as dislodgement of the tube or airway obstruction. Endotracheal cuff pressure greater than 25 cm H2O, decreased lung compliance, and bilateral crackles with increased secretions are important assessments but do not directly address the urgent need to intervene when a high-pressure alarm is triggered.

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