Nursing Elites

1. A nurse in a provider's office is assessing a client who reports a decrease in the effectiveness of their arthritis medication. Which client information should the nurse identify as a contributing factor to the decrease in the medication's effectiveness?

• A. Taking the medication with water
• B. Skipping doses of medication
• C. A history of recurring bowel inflammation
• D. Taking anti-inflammatory medication without food

Correct answer: C

Rationale: The correct answer is C. A history of recurring bowel inflammation can impact the absorption and effectiveness of arthritis medication. Bowel inflammation can affect the body's ability to absorb the medication properly, leading to decreased effectiveness. Choices A, B, and D do not directly relate to the decreased effectiveness of the arthritis medication. Taking medication with water, skipping doses, or taking anti-inflammatory medication without food may not be ideal practices but are not directly linked to the decrease in effectiveness reported by the client.

2. A nurse is caring for a client 4 hours postoperative following a thyroidectomy who reports fullness in the throat. What should the nurse assess for?

• A. Hypocalcemia
• B. Hemorrhage
• C. Hypoxia
• D. Hypothyroidism

Correct answer: B

Rationale: Fullness in the throat after a thyroidectomy could indicate bleeding or a hematoma, which can compress the airway, so hemorrhage is the priority concern. Hypocalcemia typically presents with symptoms like tingling around the mouth or in the extremities, muscle cramps, or seizures, not fullness in the throat. Hypoxia would manifest with symptoms like shortness of breath, confusion, or cyanosis, rather than a feeling of fullness in the throat. Hypothyroidism symptoms include fatigue, weight gain, and cold intolerance, but it does not typically cause acute fullness in the throat postoperatively.

3. During triage following a mass casualty event, which client should be prioritized?

• A. A client with massive head trauma
• B. A client with full-thickness burns to the face and trunk
• C. A client showing signs of hypovolemic shock
• D. A client with an open fracture of the lower extremity

Correct answer: C

Rationale: During triage after a mass casualty event, the client showing signs of hypovolemic shock should be prioritized. Hypovolemic shock is a life-threatening condition that requires immediate attention to restore circulation and prevent death. While clients with head trauma, burns, and fractures also need urgent care, hypovolemic shock poses an immediate threat to life and must be addressed first to stabilize the client's condition.

4. A healthcare provider is preparing to administer an influenza vaccine to an adult client. Which of the following is a contraindication?

• A. Client has a low-grade fever
• B. Client is allergic to eggs
• C. Client had recent surgery
• D. Client is on corticosteroid therapy

Correct answer: B

Rationale: The correct answer is B: Client is allergic to eggs. The influenza vaccine is contraindicated in individuals with an allergy to eggs because some influenza vaccines are produced using egg-based processes. Choices A, C, and D are not contraindications for administering the influenza vaccine. A low-grade fever, recent surgery, and corticosteroid therapy are not contraindications for receiving the influenza vaccine.

5. A nurse is preparing to administer enoxaparin to a client. Which of the following actions should the nurse take?

• A. Aspirate before injecting
• B. Massage the site after injecting
• C. Administer the injection in the abdomen
• D. Inject at a 90-degree angle

Correct answer: C

Rationale: The correct action the nurse should take when administering enoxaparin is to inject the medication in the abdomen subcutaneously. This route ensures proper absorption of the medication. Aspiration is not necessary before injecting enoxaparin as it is a subcutaneous injection, not an intramuscular injection. Massaging the site after injecting should be avoided to prevent bruising. Enoxaparin injections are typically given at a 45 to 90-degree angle, not necessarily at a strict 90-degree angle.

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