Nursing Elites

1. A 20-year-old male client is diagnosed with Ewing's sarcoma following examination for a knee injury. Which instruction is most important for the nurse to provide the client?

• A. Take analgesics regularly to reduce the pain
• B. Notify the healthcare provider if the swelling worsens
• C. Avoid weight-bearing until the injury heals
• D. Seek treatment for the sarcoma immediately

Correct answer: D

Rationale: The correct answer is to instruct the client to seek treatment for the sarcoma immediately. Ewing's sarcoma is an aggressive cancer, and prompt treatment is crucial for improving prognosis. Option A is incorrect because while pain management is important, addressing the underlying cause (sarcoma) is the priority. Option B is not as critical as seeking treatment for the sarcoma itself. Option C is not the most important instruction as the primary concern is addressing the cancer diagnosis.

2. The healthcare provider prescribes amoxicillin (Amoxil) 1.5 grams PO daily, in equally divided doses to be administered every 8 hours. The medication is available in a bottle labeled Amoxicillin (Amoxil) suspension 200 mg/5 ml. How many ml should the nurse administer every 8 hours?

• A. 10 ml
• B. 12.5 ml
• C. 15 ml
• D. 17.5 ml

Correct answer: B

Rationale: To calculate the correct dosage, first, determine the total daily dose: 1.5 grams = 1500 mg. Since the medication is 200 mg/5 ml, for 1500 mg, the nurse needs to administer 1500/200 = 7.5 times the 5 ml dose. Therefore, 7.5 x 5 ml = 37.5 ml total daily dose. To administer this every 8 hours, divide 37.5 ml by 3 (8 hours intervals in a day) to get 12.5 ml to be administered every 8 hours. Choice A, C, and D are incorrect as they do not reflect the correct calculation of the dose based on the prescription and the available concentration.

3. A client newly diagnosed with gastroesophageal reflux disease (GERD) is being taught about dietary management by a nurse. Which instruction should the nurse include?

• A. Avoid drinking milk
• B. Eat three large meals a day
• C. Avoid eating spicy foods
• D. Increase fluid intake with meals

Correct answer: C

Rationale: The correct instruction for a client with GERD is to avoid eating spicy foods. Spicy foods can exacerbate GERD symptoms by irritating the esophagus and increasing stomach acid production. Avoiding spicy foods can help reduce discomfort and prevent further irritation. Choices A, B, and D are incorrect. Drinking milk is not advised for GERD as it can trigger acid production. Eating three large meals a day can put pressure on the stomach, worsening symptoms. Increasing fluid intake with meals can lead to bloating and worsen GERD symptoms by causing the stomach to expand, pushing more acid into the esophagus.

4. The nurse is caring for a client who is 2 days post-op following an abdominal hysterectomy. The client reports feeling something 'give way' in the incision site and there is a small amount of bowel protruding from the wound. What action should the nurse take first?

• A. Apply a sterile saline dressing to the wound
• B. Notify the healthcare provider
• C. Administer pain medication
• D. Cover the wound with an abdominal binder

Correct answer: A

Rationale: In this situation, the priority action for the nurse is to apply a sterile saline dressing to the wound. This helps to cover and protect the exposed bowel, preventing infection and maintaining a moist environment for wound healing. Option B, notifying the healthcare provider, is important but should come after addressing the immediate need of covering the wound. Administering pain medication (option C) and covering the wound with an abdominal binder (option D) are not appropriate initial actions for this situation.

5. A healthcare provider is assessing a client who is receiving treatment for dehydration. Which assessment finding indicates that the client is responding to the treatment?

• A. Dry mucous membranes
• B. Increased urine output
• C. Decreased skin turgor
• D. Elevated heart rate

Correct answer: B

Rationale: Increased urine output is a positive sign indicating that the client is responding to the treatment for dehydration. It suggests that the client's kidneys are functioning better, helping to eliminate excess fluid and waste products from the body. Dry mucous membranes (Choice A) are a sign of dehydration, not improvement. Decreased skin turgor (Choice C) and elevated heart rate (Choice D) are also symptoms of dehydration and do not indicate a positive response to treatment.

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