Nursing Elites

1. A nurse is caring for a client in a mental health facility. The client’s daughter is crying and tells the nurse that she feels guilty for leaving her father in the hospital. Which of the following is an appropriate response?

• A. I’d like to know more about what’s bothering you.
• B. Why are you feeling this way?
• C. You did the right thing by bringing him here.
• D. I’m sure your father doesn’t blame you.

Correct answer: A

Rationale: The correct response is A: 'I’d like to know more about what’s bothering you.' Encouraging the daughter to express her feelings allows her to explore her emotions, which can be helpful in addressing her guilt and providing emotional support. Choice B is not as open-ended and may come across as confrontational. Choice C may invalidate the daughter's feelings of guilt by implying she shouldn't feel that way. Choice D assumes the father's emotions and may not address the daughter's feelings of guilt effectively.

2. A nurse is caring for a client who has end-stage osteoporosis and is reporting severe pain. The client’s respiratory rate is 14 per minute. Which of the following medications should the nurse prioritize administering?

• A. Promethazine
• B. Hydromorphone
• C. Ketorolac
• D. Amitriptyline

Correct answer: B

Rationale: Hydromorphone, an opioid, is the most appropriate option for managing severe pain in this context. Opioids provide fast-acting relief for acute pain associated with advanced osteoporosis. Promethazine (Choice A) is an antihistamine and not indicated for pain relief. Ketorolac (Choice C) is a nonsteroidal anti-inflammatory drug (NSAID) that may increase the risk of bleeding and is not recommended for severe pain management. Amitriptyline (Choice D) is a tricyclic antidepressant that is not the first-line treatment for severe acute pain.

3. A nurse is assessing a client who is 24 hours postpartum. Which of the following findings should the nurse report to the healthcare provider?

• A. Uterine fundus is firm and midline
• B. Client's perineal pad is saturated in 15 minutes
• C. Client reports breast tenderness when breastfeeding
• D. Client's temperature is 100.4°F

Correct answer: B

Rationale: A perineal pad saturated in 15 minutes is a sign of excessive postpartum bleeding, which requires immediate medical attention to prevent postpartum hemorrhage. The other findings are normal postpartum occurrences. A firm and midline uterine fundus indicates proper involution, breast tenderness during breastfeeding is common due to engorgement, and a temperature of 100.4°F is considered within the normal range for the postpartum period.

4. A nurse is preparing to administer medications to a client who is NPO and has an NG tube for suction. Which of the following actions should the nurse take?

• A. Mix medications with enteral feedings.
• B. Clamp the NG tube for 30 minutes after medication administration.
• C. Insert medications directly into the NG tube without dilution.
• D. Connect the NG tube to continuous suction after medication.

Correct answer: B

Rationale: The correct action for the nurse to take when administering medications to a client with an NG tube for suction who is NPO is to clamp the NG tube for 30 minutes after medication administration. This is done to allow for proper absorption of the medications before resuming suction. Choice A is incorrect because medications should not be mixed with enteral feedings as it may affect the drug's effectiveness. Choice C is incorrect as medications should not be inserted directly into the NG tube without dilution, as this can cause clogging or affect the tube. Choice D is incorrect because connecting the NG tube to continuous suction after medication administration can interfere with the absorption of the medications.

5. A menopausal client is having difficulty getting to sleep and asks what actions she should incorporate into her daily routine to promote sleep. The nurse would encourage which of the following measures to promote sleep?

• A. Consume a warm drink at bedtime
• B. Take an evening walk before bedtime
• C. Take an afternoon nap
• D. Limit alcohol and nicotine prior to bedtime

Correct answer: D

Rationale: The correct answer is D: Limit alcohol and nicotine prior to bedtime. Alcohol and nicotine are stimulants that can disrupt sleep patterns, so avoiding them before bedtime can promote better sleep. Choices A, B, and C are incorrect. Consuming a warm drink at bedtime may lead to frequent urination, disrupting sleep; taking an evening walk before bedtime may increase alertness rather than inducing sleep; and taking an afternoon nap can make it harder to fall asleep at night.

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