Nursing Elites

1. A nurse is caring for a client who has a prescription for vancomycin 1 g IV every 12 hours. The client is scheduled to have the morning dose at 0700. The nurse should schedule the trough level to be drawn at which of the following times?

• A. 2100
• B. 900
• C. 1300
• D. 1800

Correct answer: D

Rationale: The trough level of vancomycin should be drawn just before the next dose is administered, typically about 30 minutes before the scheduled dose. Since the morning dose is at 0700, the trough level should be drawn at 1800. This timing ensures an accurate measurement of the lowest concentration of the drug in the client's system before the next dose is given. Choice A (2100) is too close to the next dose, choice B (900) is too early, and choice C (1300) is also too far from the next dose.

2. A nurse is caring for a client with a prescription for ferrous sulfate. What instruction should the nurse provide?

• A. Avoid strawberries and citrus fruits
• B. Take with fluids other than coffee or tea
• C. Take on a full stomach
• D. Double the dose if you miss a dose

Correct answer: B

Rationale: The correct instruction for a client prescribed ferrous sulfate is to take it with fluids other than coffee or tea. Coffee and tea can hinder iron absorption, so it's important to take the medication with other types of fluids. Choice A is incorrect because strawberries and citrus fruits are sources of vitamin C, which actually enhance iron absorption. Choice C is incorrect because ferrous sulfate is usually recommended to be taken on an empty stomach for better absorption. Choice D is incorrect as doubling the dose of ferrous sulfate can lead to an overdose and severe side effects.

3. A client with ulcerative colitis has a new prescription for sulfasalazine. What adverse effect should the client monitor for according to the nurse?

• A. Jaundice
• B. Constipation
• C. Oral candidiasis
• D. Sedation

Correct answer: A

Rationale: The correct answer is A: Jaundice. Sulfasalazine can lead to liver toxicity, making it essential to monitor for jaundice, a sign of liver dysfunction. Choices B, C, and D are incorrect because constipation, oral candidiasis, and sedation are not commonly associated with sulfasalazine use.

4. While documenting client care, which of the following entries should the nurse identify as an example of implementing client care?

• A. Contacting the provider to report client findings
• B. Administering medications as prescribed
• C. Reviewing the client's lab results
• D. Discussing the care plan with the family

Correct answer: B

Rationale: Administering medications as prescribed is a clear example of implementing client care because it involves carrying out a specific aspect of the care plan. Contacting the provider to report client findings is more related to assessment and communication. Reviewing the client's lab results is part of assessment and data collection. Discussing the care plan with the family is focused on collaboration and planning, rather than direct implementation.

5. 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.

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