Nursing Elites

1. A client is diagnosed with tuberculosis and is placed on isoniazid (INH) and rifampin (Rifadin). The nurse should emphasize the importance of

• A. Daily use of a bronchodilator
• B. The importance of taking medication as prescribed
• C. Decreasing salt intake
• D. Avoidance of direct sunlight

Correct answer: B

Rationale: The correct answer is B: The importance of taking medication as prescribed. In the treatment of tuberculosis, adherence to the prescribed medication regimen is crucial to effectively manage the infection and prevent the development of drug resistance. Choices A, C, and D are incorrect because bronchodilators, salt intake, and sunlight exposure are not directly related to the treatment of tuberculosis with isoniazid and rifampin.

2. An adult client is admitted to the emergency department after falling from a ladder. While waiting to have a CT scan, the client requests something for a severe headache. When the nurse offers a prescribed dose of acetaminophen, the client asks for something stronger. Which intervention should the nurse implement?

• A. Administer an anti-inflammatory medication instead
• B. Explain the reason for using only non-narcotics
• C. Consult the healthcare provider about a stronger medication
• D. Administer a stronger medication as requested

Correct answer: B

Rationale: In this scenario, the nurse should explain the reason for using only non-narcotics. Following head trauma, non-narcotic medications such as acetaminophen are preferred to avoid masking symptoms of neurological changes, such as increased intracranial pressure, that could worsen after stronger pain medication. Administering an anti-inflammatory medication (Choice A) may not be appropriate as it may not address the severity of the headache. Consulting the healthcare provider about a stronger medication (Choice C) is important, but the immediate need is to educate the client on the rationale for using non-narcotic medications first. Administering a stronger medication as requested (Choice D) could potentially mask important symptoms and should be avoided in this situation.

3. A nurse is performing CPR on an adult who went into cardiopulmonary arrest. Another nurse enters the room in response to the call. After checking the client's pulse and respirations, what should be the function of the second nurse?

• A. Relieve the nurse performing CPR
• B. Go get the code cart
• C. Participate with the compressions or breathing
• D. Validate the client's advanced directive

Correct answer: C

Rationale: The correct answer is C. The second nurse should assist with compressions or breathing to ensure the patient receives adequate care during CPR. This immediate intervention is crucial in maintaining blood circulation and oxygenation to vital organs. Choice A is incorrect because simply relieving the nurse performing CPR may lead to a delay in essential life-saving measures. Choice B is incorrect as the primary focus should be on providing direct assistance rather than fetching equipment. Choice D is incorrect as validating the client's advanced directive is not the priority in this emergency situation.

4. A client with hypothyroidism is prescribed levothyroxine. What assessment finding suggests the medication dosage is too high?

• A. Increased sensitivity to cold.
• B. Increased heart rate and palpitations.
• C. Improved energy levels.
• D. Improved tolerance to heat.

Correct answer: B

Rationale: The correct answer is B: Increased heart rate and palpitations. When a client with hypothyroidism is prescribed levothyroxine, these symptoms may indicate that the dosage is too high, causing the client to develop hyperthyroidism. Choices A, C, and D are incorrect. Increased sensitivity to cold is a symptom of hypothyroidism, improved energy levels are an expected outcome of levothyroxine therapy for hypothyroidism, and improved tolerance to heat is not a common sign of levothyroxine overdose.

5. While palpating the gallbladder of a mildly obese client, what finding does the nurse expect if the gallbladder is inflamed?

• A. Severe tenderness and guarding
• B. Slight discomfort upon palpation
• C. A sensation of fullness
• D. No symptoms unless the gallbladder is extremely inflamed

Correct answer: A

Rationale: Correct. If the gallbladder is inflamed, the nurse would expect to find severe tenderness and guarding, which are typical signs of acute cholecystitis. This indicates an inflammatory process in the gallbladder. Choices B, C, and D are incorrect because slight discomfort, a sensation of fullness, or no symptoms unless extremely inflamed are not typical findings associated with gallbladder inflammation.

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