Nursing Elites

1. Which of the following medications should be held 24-48 hours prior to an electroencephalogram (EEG)?

• A. Lasix (furosemide)
• B. Cardizem (diltiazem)
• C. Lanoxin (digoxin)
• D. Dilantin (phenytoin)

Correct answer: D

Rationale: Anticonvulsants like Dilantin should be held 24-48 hours before an EEG to prevent interference with the test results. Medications such as tranquilizers, barbiturates, and other sedatives should also be avoided. Lasix, Cardizem, and Lanoxin do not belong to these categories and are not known to interfere with EEG results.

2. While repositioning a comatose client, the nurse senses a tingling sensation as she lowers the bed. What action should she take?

• A. Unplug the bed's power source.
• B. Remove the client from the bed immediately.
• C. Notify the biomedical department at once.
• D. Turn off the oxygen.

Correct answer: A

Rationale: The correct action for the nurse to take when sensing a tingling sensation while lowering the bed with a comatose client is to unplug the bed's power source. This should be the initial step as there may be a fault in the bed's grounding. Removing the client from the bed immediately is not safe until the electrical issue is resolved. Notifying the biomedical department is important but should come after ensuring the immediate safety of the client. Turning off the oxygen is not necessary unless there is a specific issue related to oxygen delivery, which is not indicated in this scenario.

3. A case manager is reviewing the records of the clients in the nursing unit. Which note(s) in a client's record indicate an unexpected outcome and the need for follow-up?

• A. A client is performing their own colostomy irrigations.
• B. A client with a central venous catheter has a temperature of 100.6�F.
• C. A client who has just undergone surgery has a urine output of more than 30 mL/hr.
• D. A client with a new diagnosis of diabetes mellitus is self-administering insulin.

Correct answer: B

Rationale: A case manager is a healthcare professional responsible for coordinating a client's care from admission through and after discharge. They evaluate and update the plan of care as needed, monitoring for unexpected outcomes and providing follow-up. A temperature of 100.6�F in a client with a central venous catheter is an unexpected outcome that requires follow-up due to the potential indication of an infection. Choices A, C, and D describe expected outcomes and appropriate self-care management. The client self-irrigating their colostomy, a post-surgical client having adequate urine output, and a newly diagnosed diabetic self-administering insulin are all positive indicators of self-care and expected outcomes, not requiring immediate follow-up.

4. The nurse is teaching a client about communicable diseases and explains that a portal of entry is:

• A. a vector.
• B. a source, like contaminated water.
• C. food.
• D. the respiratory system.

Correct answer: D

Rationale: The correct answer is 'the respiratory system.' A portal of entry is the path through which a microorganism enters the body. In the case of communicable diseases, the respiratory system can serve as a portal of entry for pathogens such as viruses or bacteria. Choices A, B, and C are incorrect. A 'vector' is an organism that transmits disease, not the entry point for pathogens. Contaminated water or food can act as sources or reservoirs of disease-causing microorganisms, not portals of entry.

5. The healthcare provider sustains a needle puncture that requires HIV prophylaxis. Which of the following medication regimens should be used?

• A. an antibiotic such as Metronidazole and a protease inhibitor (Saquinavir)
• B. two non-nucleoside reverse transcriptase inhibitors
• C. one protease inhibitor such as Nelfinavir
• D. two protease inhibitors

Correct answer: B

Rationale: In the scenario of a needle puncture requiring HIV prophylaxis, the CDC recommends initiating treatment with two non-nucleoside reverse transcriptase inhibitors, unless there is drug resistance. This regimen is preferred over other options such as a single protease inhibitor or two protease inhibitors due to its effectiveness and safety profile in this specific context. Non-nucleoside reverse transcriptase inhibitors are commonly used in post-exposure prophylaxis due to their activity against HIV and lower risk of resistance development compared to other antiretroviral drug classes.

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