Nursing Elites

1. After a case manager completes a history and physical assessment for a client with COPD, which of the following actions should the case manager take next?

• A. Call the provider with a list of client concerns.
• B. Identify the client's current health needs.
• C. Compile a list of community resources for the client.
• D. Refer the client to a COPD support group.

Correct answer: A

Rationale: After completing a history and physical assessment for a client with COPD, the next step for the case manager should be to call the provider with a list of client concerns. This is crucial as the provider needs to be informed about any issues or changes in the client's health status to ensure appropriate management. Identifying the client's current health needs, as mentioned in option B, is important but would typically follow after communicating the client's concerns to the provider. Compiling a list of community resources (option C) and referring the client to a COPD support group (option D) are also valuable actions but are not the immediate next steps after completing the assessment.

2. A nurse enters a client's room to administer a prescribed medication, and the client asks about the medication. What is the most appropriate response by the nurse?

• A. Give detailed information about the medication, including its potential side effects.
• B. Refer the client to the healthcare provider for more information.
• C. Give a brief explanation and administer the medication.
• D. Ask another nurse to explain the medication and proceed.

Correct answer: B

Rationale: The most appropriate response for the nurse when a client asks about a medication is to refer the client to the healthcare provider for more information. This ensures that the client receives accurate and detailed information from the appropriate source. Providing detailed information or a brief explanation as choices A and C suggest may not be within the nurse's scope of practice and could potentially lead to misinformation or confusion. Asking another nurse to explain the medication, as in choice D, may not guarantee accurate information, so it is best to involve the healthcare provider directly.

3. A nurse is preparing to administer digoxin 0.25 mg PO daily. The amount available is digoxin 0.125 mg tablets. How many tablets should the nurse administer?

• A. 1
• B. 2
• C. 3
• D. 4

Correct answer: B

Rationale: The correct answer is B: 2. To achieve the prescribed dose of 0.25 mg of digoxin, the nurse should administer two 0.125 mg tablets. This calculation ensures that the patient receives the correct amount of medication. Choices A, C, and D are incorrect because they do not reflect the accurate dosage needed based on the available tablets and prescribed dose.

4. What is the priority when assessing a patient for possible deep vein thrombosis (DVT)?

• A. Dorsiflex the foot and check for pain.
• B. Measure the calf circumference of both legs.
• C. Check the skin for signs of redness.
• D. Perform a Doppler ultrasound scan.

Correct answer: B

Rationale: The correct answer is to measure the calf circumference of both legs when assessing a patient for possible DVT. An increase in calf circumference in one leg can indicate the presence of a DVT. Option A is incorrect because dorsiflexing the foot and checking for pain are not primary assessments for DVT. Option C is incorrect as redness of the skin may not always be present in cases of DVT. Option D is incorrect as performing a Doppler ultrasound scan is usually done after clinical assessment and to confirm the diagnosis, not as the initial priority assessment.

5. A healthcare provider prescribes a higher-than-usual dose of medication. What is the nurse's first action?

• A. Administer the medication and monitor closely.
• B. Hold the medication and consult the pharmacist.
• C. Ask another nurse to verify the dose.
• D. Call the provider for clarification.

Correct answer: D

Rationale: The correct answer is to call the provider for clarification. When faced with a higher-than-usual dose of medication, the nurse's first action should be to contact the prescribing healthcare provider to confirm the dosage. Administering the medication without clarifying the dose with the provider can pose serious risks to the patient's safety. Holding the medication and consulting the pharmacist may be appropriate after contacting the provider for clarification. Asking another nurse to verify the dose is not the most appropriate action when dealing with an unusual prescription; direct communication with the provider is essential in such situations.

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