Nursing Elites

1. After checking the client’s gag reflex following an esophagogastroduodenoscopy (EGD), which action should the nurse take?

• A. Taking the client’s vital signs
• B. Giving the client a drink of water
• C. Monitoring the client for a sore throat
• D. Being alert to complaints of heartburn

Correct answer: A

Rationale: After an esophagogastroduodenoscopy (EGD), the nurse's priority is to assess the client's airway by checking the gag reflex. Once this assessment is done, the next step is to take the client's vital signs to monitor for any signs of complications such as bleeding or changes in respiratory status. Giving the client water immediately after the procedure may not be appropriate, as the client may still have a compromised gag reflex and is at risk for aspiration. Monitoring for a sore throat is important but not the immediate priority post-procedure. Being alert to complaints of heartburn is relevant for assessing the client's symptoms but is not the priority immediately after checking the gag reflex.

2. The client is preparing a morning dose of insulin, which includes 10 units of regular and 22 units of NPH. The nurse is verifying the client's preparation accuracy. What should the syringe read for the correct dose?

• A. 22 units.
• B. 10 units.
• C. 32 units.
• D. 42 units.

Correct answer: C

Rationale: The correct answer is 32 units. To determine the correct dose, the nurse needs to add the 10 units of regular insulin to the 22 units of NPH, resulting in a total of 32 units. Therefore, the syringe should read 32 units. Choices A, B, and D are incorrect because they do not reflect the accurate total dose required for the morning insulin administration.

3. The healthcare provider is unable to palpate the client's left pedal pulses. Which of the following actions should the healthcare provider take next?

• A. Auscultate the pulses with a stethoscope.
• B. Call the physician.
• C. Use a Doppler ultrasound device.
• D. Inspect the lower left extremity.

Correct answer: C

Rationale: When pedal pulses are not palpable, using a Doppler ultrasound device is the appropriate next step to locate the pulse. Auscultating the pulses with a stethoscope (Choice A) is used for assessing blood flow in arteries above the clavicle, not for pedal pulses. Calling the physician (Choice B) may be necessary at a later stage, but initially, using a Doppler ultrasound device to locate the pulse is more appropriate. Inspecting the lower left extremity (Choice D) can provide visual information but will not help in locating the pedal pulses, making it a less suitable option.

4. Which of the following is a priority intervention for a patient with suspected sepsis?

• A. Administering antibiotics.
• B. Administering IV fluids.
• C. Administering antipyretics.
• D. Monitoring blood cultures.

Correct answer: D

Rationale: Monitoring blood cultures is a crucial intervention in suspected sepsis because it helps identify the causative organism, which is essential for guiding appropriate antibiotic therapy. Administering antibiotics (Choice A) is important but should be guided by blood culture results. Administering IV fluids (Choice B) is also essential to support hemodynamic stability in sepsis. Administering antipyretics (Choice C) may help reduce fever but is not a priority compared to identifying the causative organism through blood cultures.

5. The patient will take a high dose of azithromycin after discharge from the hospital. Which statement by the patient indicates understanding of the teaching?

• A. I may take antacids 2 hours before taking this drug.
• B. I should take acetaminophen for fever or mild pain.
• C. I should expect diarrhea to be a common, mild side effect.
• D. I should avoid dairy products while taking this drug.

Correct answer: A

Rationale: The correct answer is A. Azithromycin peak levels may be reduced by antacids when taken at the same time, so patients should be cautioned to take antacids 2 hours before or 2 hours after taking the drug. Choice B is incorrect because high-dose azithromycin carries a risk for hepatotoxicity when taken with other potentially hepatotoxic drugs such as acetaminophen. Choice C is incorrect as diarrhea may indicate pseudomembranous colitis and should be reported, not expected as a common mild side effect. Choice D is incorrect; there is no restriction for dairy products while taking azithromycin.

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