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 client is being taught about the use of nitroglycerin. Which of the following should be included?

• A. Take it with food
• B. Place the tablet under the tongue
• C. It can be stored in the refrigerator
• D. It has no side effects

Correct answer: B

Rationale: The correct answer is to place the nitroglycerin tablet under the tongue. Nitroglycerin tablets are meant for sublingual absorption during angina episodes to provide quick relief. Option A is incorrect because nitroglycerin should not be taken with food. Option C is incorrect as nitroglycerin should be stored in a cool, dark place, not in the refrigerator. Option D is incorrect because nitroglycerin can have side effects, including headaches, dizziness, and low blood pressure.

3. A client newly diagnosed with osteoporosis is being taught by a nurse about preventing complications. Which food should the nurse recommend?

• A. Fried chicken
• B. Whole milk
• C. Oatmeal
• D. Bacon

Correct answer: C

Rationale: Oatmeal is an excellent recommendation for clients with osteoporosis due to its richness in fiber and nutrients, making it a heart-healthy and bone-friendly choice. Fried chicken (Choice A) is high in unhealthy fats and lacks the nutrients needed for bone health. Whole milk (Choice B) contains calcium but can be high in saturated fats, which may not be the best choice for individuals with osteoporosis. Bacon (Choice D) is high in saturated fats and sodium, which can have negative effects on bone health and overall well-being.

4. A nurse is caring for a client with a new prescription for enoxaparin to prevent DVT. Which of the following is an appropriate action by the nurse?

• A. Expel any air bubbles from the prefilled syringe
• B. Inject the medication in the lateral abdominal wall
• C. Massage the injection site to evenly distribute the medication
• D. Administer NSAIDs for injection site discomfort

Correct answer: B

Rationale: The correct answer is to inject enoxaparin in the lateral abdominal wall. This site is typically recommended for subcutaneous injections of this medication. Expelling air bubbles from prefilled syringes is not necessary and may result in medication loss. Massaging the injection site is contraindicated as it can cause bruising or hematoma formation. Administering NSAIDs for injection site discomfort is unnecessary and not a standard practice.

5. A healthcare professional is assessing a client for signs of fluid overload. Which of the following findings should the healthcare professional look for?

• A. Weight loss
• B. Decreased blood pressure
• C. Edema
• D. Increased urine output

Correct answer: C

Rationale: Edema is a common sign of fluid overload. When the body retains more fluid than it excretes, it can lead to edema, which is swelling caused by excess fluid trapped in body tissues. Weight gain, not weight loss, is typically associated with fluid overload due to the retained fluids. Decreased blood pressure is more commonly associated with dehydration rather than fluid overload. Increased urine output is a sign of the body trying to eliminate excess fluids, which is contrary to the signs of fluid overload.

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