Nursing Elites

1. A nurse in a clinic is caring for a patient who has a UTI. What prescription should the nurse verify with a provider?

• A. Ciprofloxacin
• B. Trimethoprim-sulfamethoxazole
• C. Oxybutynin
• D. Nitrofurantoin

Correct answer: C

Rationale: The correct answer is C: Oxybutynin. Oxybutynin is an anticholinergic used to treat overactive bladder, not a UTI. The nurse should verify this prescription because it may not be appropriate for a UTI. Choices A, B, and D are antibiotics commonly used in the treatment of UTIs. Ciprofloxacin, trimethoprim-sulfamethoxazole, and nitrofurantoin are more suitable choices for the treatment of a UTI compared to oxybutynin.

2. A nurse is caring for an older adult patient who is disoriented and has a history of falls. What actions should the nurse take?

• A. Place the bed in the lowest position, instruct the patient to remain in bed, ensure the bedside table is within reach.
• B. Instruct the patient to use the call light, apply an ambulation alarm to the patient’s leg, check on the patient hourly.
• C. Assign a sitter to monitor the patient, raise the bed rails, provide the patient with a call button.
• D. Check on the patient every two hours, provide verbal reminders to use the call light, lock the bed wheels.

Correct answer: B

Rationale: In this scenario, the correct actions for the nurse to take involve ensuring patient safety and fall prevention measures. Choice B is the correct answer because instructing the patient to use the call light allows them to signal for help, applying an ambulation alarm helps detect movement, and checking on the patient hourly increases monitoring frequency. These actions are essential for preventing falls in a disoriented patient with a history of falls. Choices A, C, and D are incorrect: A does not provide adequate monitoring or fall prevention measures, C relies solely on assigning a sitter without utilizing technological aids, and D lacks continuous monitoring and specific fall prevention strategies.

3. A client with preeclampsia is receiving magnesium sulfate intravenously. What action should the nurse take if the client develops toxicity?

• A. Position the client supine
• B. Prepare an IV bolus of dextrose 5%
• C. Administer calcium gluconate IV
• D. Administer methylergonovine IM

Correct answer: C

Rationale: In cases of magnesium sulfate toxicity, calcium gluconate is the antidote as it helps reverse the effects. Positioning the client supine (Choice A) may not directly address magnesium sulfate toxicity. Administering dextrose 5% (Choice B) is not the correct intervention for magnesium sulfate toxicity. Methylergonovine IM (Choice D) is used to manage postpartum hemorrhage, not magnesium sulfate toxicity.

4. A nurse is caring for a client prescribed gabapentin. Which of the following should the nurse monitor?

• A. Liver function tests
• B. Renal function
• C. Blood glucose levels
• D. Cardiac rhythm

Correct answer: B

Rationale: The correct answer is B: Renal function. Gabapentin is primarily eliminated by the kidneys, so monitoring renal function is essential to ensure the drug is being cleared effectively from the body. Monitoring liver function tests (choice A) is not a priority for gabapentin as it is not primarily metabolized by the liver. Blood glucose levels (choice C) are not directly impacted by gabapentin. Cardiac rhythm (choice D) monitoring is not typically necessary for clients on gabapentin unless they have pre-existing cardiac conditions that may be exacerbated by the medication.

5. A nurse is performing a focused assessment for a client who has dysrhythmias. What indicates ineffective cardiac contractions?

• A. Increased blood pressure
• B. Pulse deficit
• C. Normal heart rate
• D. Elevated oxygen saturation

Correct answer: B

Rationale: The correct answer is B: Pulse deficit. A pulse deficit is a significant finding in clients with dysrhythmias, indicating ineffective cardiac contractions. Pulse deficit occurs when there is a difference between the apical and radial pulses, suggesting that not all heart contractions are strong enough to produce a pulse that can be felt peripherally. Increased blood pressure (choice A) may occur due to various factors and is not a direct indicator of ineffective cardiac contractions. Similarly, a normal heart rate (choice C) and elevated oxygen saturation (choice D) do not specifically point towards ineffective cardiac contractions; they can be present in individuals with dysrhythmias but do not directly indicate ineffective cardiac contractions.

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