Nursing Elites

1. A newly licensed nurse tells a charge nurse he is unsure about accepting telephone medication prescriptions. Which of the following providers should the charge nurse identify as having the legal ability to give telephone medication prescriptions?

• A. Nurse midwives
• B. Physical therapists
• C. Pharmacists
• D. Physician assistants

Correct answer: D

Rationale: Physician assistants are healthcare providers who are licensed to prescribe medications. They have the legal ability to give telephone orders for medications. Nurse midwives primarily focus on providing prenatal care and assisting during labor and delivery. Physical therapists specialize in rehabilitation services. Pharmacists dispense medications and provide medication counseling. Therefore, among the options provided, physician assistants are the correct choice for giving telephone medication prescriptions.

2. A nurse is monitoring a client who has been receiving intermittent enteral feedings. What should the nurse identify as an intolerance to the feeding?

• A. Increased appetite
• B. Nausea
• C. Weight gain
• D. Regular bowel movements

Correct answer: B

Rationale: Nausea is a common sign of intolerance to enteral feedings. When a client experiences nausea, it can indicate difficulty in tolerating the feeding formula. This intolerance may also manifest as vomiting and dumping syndrome. Choices A, C, and D are incorrect because increased appetite, weight gain, and regular bowel movements are not typical signs of intolerance to enteral feedings.

3. A nurse is caring for a client who has chronic kidney disease. The nurse should identify which of the following laboratory values as an indication for hemodialysis?

• A. Glomerular filtration rate of 14 mL/min
• B. BUN 16 mg/dL
• C. Serum magnesium 1.8 mg/dL
• D. Serum phosphorus 4.0 mg/dL

Correct answer: A

Rationale: A glomerular filtration rate (GFR) of 14 mL/min indicates severely impaired kidney function, often necessitating hemodialysis to support renal function and manage fluid and electrolyte balance. A BUN level of 16 mg/dL falls within the normal range (7-20 mg/dL) and does not specifically indicate the need for hemodialysis. Serum magnesium at 1.8 mg/dL and serum phosphorus at 4.0 mg/dL are also within normal ranges and do not typically prompt the immediate need for hemodialysis in chronic kidney disease.

4. A client who is 28 weeks pregnant and has preeclampsia is being cared for by a nurse. Which of the following is the priority assessment?

• A. Level of consciousness
• B. Deep tendon reflexes
• C. Blood pressure
• D. Urinary output

Correct answer: C

Rationale: Blood pressure is the priority assessment in clients with preeclampsia because hypertension is the primary symptom of the condition. Elevated blood pressure increases the risk of complications such as eclampsia and placental abruption. Assessing the blood pressure helps in monitoring the severity of the preeclampsia and guiding appropriate interventions. While monitoring the client's level of consciousness, deep tendon reflexes, and urinary output are important, they are secondary assessments in the context of preeclampsia.

5. A nurse is assessing a client for potential drug interactions. Which of the following factors should the nurse consider?

• A. Client's diet
• B. Client's age
• C. Client's genetic background
• D. All of the above

Correct answer: D

Rationale: Correct! All of these factors should be considered when assessing a client for potential drug interactions. The client's diet can interact with certain medications, the client's age can affect metabolism and drug sensitivity, and genetic background can impact how the body processes medications. Therefore, it is essential for the nurse to take into account all these factors to ensure safe and effective drug therapy. Choices A, B, and C are incorrect because each of these factors alone can contribute to potential drug interactions, making it crucial to consider all of them together.

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