Nursing Elites

1. A community health nurse is helping to reinforce teaching about hepatitis A with a group of employees at a childcare facility. Which of the following characteristics should the nurse identify as an external factor that can impede learning for the participants?

• A. High workload
• B. Limited knowledge on the subject
• C. Poor lighting
• D. Limited space in the learning area

Correct answer: C

Rationale: The correct answer is C: 'Poor lighting.' External factors such as lighting can significantly impact the learning environment, making it difficult for participants to engage effectively. Poor lighting can strain the eyes, cause discomfort, and lead to decreased concentration. Choices A, B, and D are internal factors or issues that are not directly related to the learning environment. High workload, limited knowledge on the subject, and limited space in the learning area may affect learning differently but do not impede learning through external factors like poor lighting does.

2. What are the nursing considerations for a patient receiving anticoagulant therapy?

• A. Monitor INR levels and check for bleeding
• B. Educate patient on dietary restrictions
• C. Ensure adequate hydration and nutrition
• D. Ensure that the patient remains immobile

Correct answer: A

Rationale: The correct answer is A: 'Monitor INR levels and check for bleeding.' When a patient is receiving anticoagulant therapy, nurses must monitor the patient's INR levels to ensure that the anticoagulants are within the therapeutic range and also watch for signs of bleeding, which is a common side effect of anticoagulants. Option B is incorrect because while patient education is important, dietary restrictions are not a direct nursing consideration when administering anticoagulant therapy. Option C is not a specific nursing consideration related to anticoagulant therapy. Option D is incorrect as keeping the patient immobile is not a standard nursing practice for patients on anticoagulant therapy, as mobility is often encouraged to prevent complications like deep vein thrombosis.

3. How should a healthcare professional assess and manage a patient with acute renal failure?

• A. Monitor urine output and administer diuretics
• B. Administer IV fluids and restrict potassium intake
• C. Monitor electrolyte levels and provide dietary education
• D. Administer potassium and restrict fluids

Correct answer: A

Rationale: In acute renal failure, it is crucial to monitor urine output to assess kidney function and fluid balance. Administering diuretics helps manage fluid levels by promoting urine production. Choice B is incorrect because administering IV fluids can worsen fluid overload in renal failure patients, and restricting potassium intake is not typically the initial approach. Choice C is not the primary intervention but is important for long-term management. Choice D is incorrect as administering potassium can be dangerous in renal failure, and restricting fluids can lead to dehydration.

4. A nurse is preparing to administer medications to a client who is NPO and is receiving enteral feedings through an NG tube. Which of the following prescriptions should the nurse clarify with the provider?

• A. Metoprolol ER 50 mg via NG tube BID
• B. Acetaminophen 650 mg PO BID
• C. Lisinopril 10 mg PO daily
• D. Ondansetron 4 mg IV push PRN

Correct answer: B

Rationale: The nurse should clarify prescription B, Acetaminophen 650 mg PO BID, with the provider. When a patient is NPO and receiving enteral feedings through an NG tube, medications administered orally may be contraindicated due to the risk of aspiration. Therefore, Acetaminophen should be confirmed for safety in this situation. The other options (Metoprolol ER 50 mg via NG tube BID, Lisinopril 10 mg PO daily, Ondansetron 4 mg IV push PRN) are appropriate and do not need clarification in this scenario.

5. A client has an NG tube that needs irrigation every 8 hours. Which solution should be used to irrigate the tube to maintain fluid and electrolyte balance?

• A. Tap water
• B. Sterile water
• C. 0.9% sodium chloride
• D. 0.45% sodium chloride

Correct answer: C

Rationale: The correct answer is 0.9% sodium chloride. This solution is isotonic and helps maintain electrolyte balance during irrigation, preventing fluid and electrolyte imbalances. Tap water (choice A) may cause electrolyte imbalances due to its hypotonic nature. Sterile water (choice B) is hypotonic and can lead to electrolyte disturbances. 0.45% sodium chloride (choice D) is hypotonic and may also disrupt electrolyte balance when used for irrigation.

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