Nursing Elites

1. A client with a UTI and a history of recurrent infections asks why the provider has not yet prescribed an antibiotic. The nurse should explain that the provider has to wait for the results of which of the following laboratory tests to identify which antibiotic to prescribe?

• A. Gram stain
• B. Culture
• C. Sensitivity
• D. Specific gravity

Correct answer: C

Rationale: In the case of a UTI, a sensitivity test is crucial as it identifies the most effective antibiotic to target the specific microorganism causing the infection. This test helps in prescribing the appropriate antibiotic for successful treatment and preventing antibiotic resistance. While a Gram stain and culture are important in diagnosing a UTI, the sensitivity test specifically determines the most suitable antibiotic. Specific gravity, on the other hand, is not related to identifying the appropriate antibiotic for a UTI.

2. A client who is withdrawing from alcohol has been prescribed Propranolol. Which information should the nurse include in the teaching?

• A. Increases the risk for seizure activity.
• B. Provides a form of aversion therapy.
• C. Decreases cravings.
• D. Results in mild hypertension.

Correct answer: C

Rationale: The correct information the nurse should include in the teaching is that Propranolol decreases cravings for alcohol. Propranolol is used as an adjunct medication during alcohol withdrawal to help reduce the desire for alcohol. Choice A is incorrect as Propranolol does not increase the risk for seizure activity; it can actually be used to prevent alcohol withdrawal seizures. Choice B is also incorrect as Propranolol does not provide aversion therapy. Choice D is incorrect as Propranolol is not known to result in mild hypertension.

3. A client with peptic ulcer disease is being taught about managing the condition. Which of the following statements indicates an understanding of the teaching?

• A. I should eat small, frequent meals that are low in fiber.
• B. I will limit my intake of caffeine-containing beverages.
• C. I should take NSAIDs to relieve my pain.
• D. I will drink milk before bedtime to decrease acid production.

Correct answer: B

Rationale: The correct answer is B: 'I will limit my intake of caffeine-containing beverages.' Limiting intake of caffeine-containing beverages is important for managing peptic ulcer disease as caffeine can stimulate gastric acid secretion, which may worsen the condition. It is advisable to choose decaffeinated beverages and avoid caffeinated drinks to help reduce the risk of aggravating the ulcer. Choices A, C, and D are incorrect. Choice A suggests eating small, frequent meals low in fiber, which is not ideal for managing peptic ulcer disease. Choice C of taking NSAIDs is contraindicated as NSAIDs can worsen peptic ulcers. Choice D of drinking milk before bedtime to decrease acid production is a common misconception; while milk may temporarily neutralize stomach acid, it can stimulate more acid production later, making the condition worse.

4. What is a serious adverse reaction to penicillin?

• A. Liver Failure
• B. Anaphylaxis
• C. Respiratory Depression
• D. Edema

Correct answer: B

Rationale: The correct answer is B: Anaphylaxis. Anaphylaxis is a severe allergic reaction that can occur as a serious adverse reaction to penicillin. It is a life-threatening condition that requires immediate medical attention. Choices A, C, and D are incorrect. Liver failure is not a typical adverse reaction to penicillin, respiratory depression is more commonly associated with opioid medications, and edema is not a common severe adverse reaction to penicillin.

5. The healthcare professional is preparing to administer atenolol (Tenormin) to a client with angina. Which vital sign would cause the healthcare professional to question administering this drug?

• A. Respirations 12 breaths per minute
• B. Pulse 52 beats per minute
• C. Blood pressure 134/72
• D. Oxygen saturation 95%

Correct answer: B

Rationale: Atenolol is a beta-blocker medication that can lower heart rate. A pulse of 52 beats per minute is relatively low and administering atenolol could further decrease the heart rate, potentially leading to bradycardia. Monitoring the pulse rate and holding the medication if the pulse is below the prescribed parameters is crucial to prevent adverse effects such as bradycardia and hypotension.

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