Nursing Elites

1. A health care provider has prescribed isoniazid (Laniazid) for a client. Which instruction should the LPN give the client about this medication?

• A. Prolonged use does not typically cause dark concentrated urine.
• B. It is not necessary to take the medication on an empty stomach for optimal absorption.
• C. Avoid taking the medication with aluminum hydroxide to minimize GI upset.
• D. Drinking alcohol daily can cause drug-induced hepatitis.

Correct answer: D

Rationale: The correct answer is D. When taking isoniazid, alcohol consumption should be avoided as it can increase the risk of liver damage, potentially leading to drug-induced hepatitis. Choices A, B, and C are incorrect. Prolonged use of isoniazid does not typically cause dark concentrated urine; it is not necessary to take the medication on an empty stomach for optimal absorption; and it is not recommended to take isoniazid with aluminum hydroxide to minimize GI upset.

2. A nurse is providing care to four clients. Which of the following situations requires the nurse to complete an incident report?

• A. A nurse tied a client's restraints straps to the moveable part of the bed frame.
• B. An assistive personnel placed a surgical mask on a client who has TB before transporting her to radiology.
• C. A nurse administered a medication to a client 30 minutes before the dose is due.
• D. A client who has an IV infusion pump receives an additional 250 mL of IV fluid.

Correct answer: C

Rationale: The correct answer is C. An incident report should be completed when a nurse administers medication to a client significantly earlier than the scheduled time. This deviation from the prescribed schedule could potentially impact the client's treatment plan and requires documentation for proper evaluation and follow-up. Choices A, B, and D do not necessarily require an incident report. Choice A involves improper restraint application, which is a safety issue but does not directly involve medication administration. Choice B involves a protective measure for a client with TB, which is within the scope of practice for assistive personnel. Choice D describes an increase in IV fluid administration, which may need monitoring but does not necessarily indicate a need for an incident report unless there are specific complications or adverse effects related to the additional fluid.

3. A client has been tentatively diagnosed with Graves' disease (hyperthyroidism). Which of these findings noted on the initial nursing assessment requires quick intervention by the nurse?

• A. A report of 10 pounds weight loss in the last month
• B. A comment by the client 'I just can't sit still.'
• C. The appearance of eyeballs that appear to 'pop' out of the client's eye sockets
• D. A report of the sudden onset of irritability in the past 2 weeks

Correct answer: C

Rationale: The appearance of eyeballs that appear to 'pop' out of the client's eye sockets, known as exophthalmos, requires quick intervention as it is a severe symptom of Graves' disease. Exophthalmos can indicate an acute condition and may lead to serious complications such as optic nerve damage or corneal ulceration. Weight loss, restlessness, and irritability are common manifestations of hyperthyroidism but do not pose immediate risks compared to the ocular complications associated with exophthalmos.

4. During an admission assessment of an older adult client, a nurse should identify which of the following findings as a potential indication of abuse?

• A. Bruises on the arms in various stages of healing
• B. Recent weight gain
• C. Complaints of joint pain
• D. Frequent visits to different providers

Correct answer: A

Rationale: Bruises on the arms in various stages of healing should be identified as a potential indication of abuse in an older adult. These bruises may suggest physical harm or neglect, which are concerning signs of abuse. Recent weight gain (Choice B) is not typically associated with abuse and can have various causes, such as dietary changes or health conditions. Complaints of joint pain (Choice C) are more likely related to musculoskeletal issues rather than abuse. Frequent visits to different providers (Choice D) could indicate seeking multiple opinions or healthcare needs and do not necessarily point to abuse.

5. When preparing to lift and reposition a patient, which action should the nurse take first?

• A. Assess weight to determine assistance needs.
• B. Position a drawsheet under the patient.
• C. Delegate the task to a nursing assistive personnel.
• D. Attempt to manually lift the patient alone before asking for assistance.

Correct answer: A

Rationale: The first action the nurse should take when preparing to lift and reposition a patient is to assess the patient's weight to determine the assistance needed. This step is crucial for the safety of both the patient and the nurse. Positioning a drawsheet under the patient (Choice B) is important for the comfort and safety during the repositioning process but should come after assessing the weight and assistance requirements. Delegating the task to a nursing assistive personnel (Choice C) can be considered once the assessment is complete and additional help is needed. Attempting to manually lift the patient alone before asking for assistance (Choice D) is unsafe and should never be done without first assessing the weight and determining the need for help.

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