Nursing Elites

1. When placing an IV line in a patient with active TB and HIV, which safety equipment should the nurse wear?

• A. Sterile gloves, mask, and goggles
• B. Surgical cap, gloves, mask, and proper shoewear
• C. Double gloves, gown, and mask
• D. Goggles, mask, gloves, and gown

Correct answer: D

Rationale: When dealing with a patient with active TB and HIV, the nurse should wear goggles, a mask, gloves, and a gown to protect themselves from potential exposure to infectious agents through respiratory secretions or blood. Surgical cap and proper shoewear are not specifically required for this procedure, making option B incorrect. Double gloving is not necessary in this scenario, hence option C is incorrect. Therefore, the correct choice is D as it includes all the essential protective equipment for this situation.

2. The nurse should plan to evaluate the earliest onset of effectiveness of nitroglycerin (Nitrostat) sublingual (SL) within what time frame?

• A. 15 seconds
• B. 3 minutes
• C. 5 minutes
• D. 15 minutes

Correct answer: B

Rationale: The onset of action for Nitrostat SL is 1 to 3 minutes. Therefore, the nurse should plan to evaluate the earliest onset of effectiveness within 3 minutes after administering the medication. Option A, 15 seconds, is too short of a time frame for the onset of action of Nitrostat. Option C, 5 minutes, is slightly delayed compared to the typical onset time. Option D, 15 minutes, is too long to wait for evaluating the effectiveness of Nitrostat sublingual administration.

3. When assessing a client in the Emergency Department whose membranes have ruptured, the nurse notes that the fluid is a greenish color. What is the cause of this greenish coloration?

• A. blood
• B. meconium
• C. hydramnios
• D. caput

Correct answer: B

Rationale: The correct answer is B: meconium. Greenish amniotic fluid passed when the fetus is in a cephalic (head) presentation might indicate fetal distress. A fetus in the breech presentation passes meconium due to compression on the intestinal tract. Choice A, blood, is incorrect as blood in the amniotic fluid would present as a different color. Choice C, hydramnios, refers to an excess of amniotic fluid and would not cause the greenish coloration. Choice D, caput, is swelling of a newborn's scalp and is not related to the color of the amniotic fluid.

4. Which of the following classifications of medications is used to help decrease tremors for clients with hyperthyroidism?

• A. Steroids
• B. Anticonvulsants
• C. Beta blockers
• D. Iodine compounds

Correct answer: C

Rationale: The correct answer is Beta blockers. Beta blockers are commonly used to help decrease tremors in clients with hyperthyroidism by blocking the action of adrenaline. This helps to control symptoms such as rapid heart rate, tremors, and anxiety. Steroids (Choice A) are not typically used to treat tremors in hyperthyroidism. Anticonvulsants (Choice B) are primarily used to control seizures and are not the first-line treatment for tremors in hyperthyroidism. Iodine compounds (Choice D) are used in the treatment of hyperthyroidism by reducing the production of thyroid hormones but are not specifically indicated for tremor relief.

5. The PN is caring for a client with diabetes insipidus. The nurse can expect the lab work to show:

• A. elevated urine osmolarity and elevated serum osmolarity.
• B. decreased urine osmolarity and decreased serum osmolarity.
• C. elevated urine osmolarity and decreased serum osmolarity.
• D. decreased urine osmolarity and elevated serum osmolarity.

Correct answer: D

Rationale: In diabetes insipidus, the pituitary releases too much antidiuretic hormone (ADH), causing the client to produce a large amount of dilute urine (decreased osmolarity) and leading to dehydration (elevated serum osmolarity). Therefore, the correct answer is decreased urine osmolarity and elevated serum osmolarity. Choice C, elevated urine osmolarity and decreased serum osmolarity, is incorrect for diabetes insipidus, as it is more characteristic of syndrome of inappropriate ADH (SIADH). Choices A and B, elevated urine osmolarity and elevated serum osmolarity, and decreased urine osmolarity and decreased serum osmolarity, respectively, are generally not seen in diabetes insipidus, as urine and serum osmolarity typically move in opposite directions in this condition.

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